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Home My WebLink About20142098.tiff RESOLUTION RE: APPROVE CHILD PROTECTION AGREEMENT FOR SERVICES AND AUTHORIZE CHAIR TO SIGN —THE PRIDE DIALECTIC, LLC WHEREAS, the Board of County Commissioners of Weld County, Colorado, pursuant to Colorado statute and the Weld County Home Rule Charter, is vested with the authority of administering the affairs of Weld County, Colorado, and WHEREAS, the Board has been presented with an Agreement for Services between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Services, and The Pride Dialectic, LLC, commencing July 1, 2014, and ending June 30, 2015, with further terms and conditions being as stated in said agreement, and WHEREAS, after review,the Board deems it advisable to approve said agreement, a copy of which is attached hereto and incorporated herein by reference. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the Child Protection Agreement for Services between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, on behalf of the Department of Human Services, and The Pride Dialectic, LLC, be, and hereby is, approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said agreement. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 14th day of July, A.D., 2014, nunc pro tunc July 1, 2014. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, COLORADO ATTEST: dim.,, !d �� C/6u+w DoAlad Rademacher, hair Weld County Clerk to the Board Ai) • EL 4 arbara Kirkme er, Pro-Tem BY: f, 1 . ( ►�� .l ,1� �� Dep t►Clerk to th- Board I USED Fearl P. Conway Nrcr AP D RM: �®`v\it goo Mike Fre n Coun y Attorney illiam F. arcia Date of signature: Z I f 1-15b (ST) 7-25 2014-2098 HR0085 ,86 MEMORANDUM 2 r� DATE: July 10, 2014 v COUNTY TO: Douglas Rademacher, Chair, Board of Count Commissioners FROM: Judy A. Griego, Director RE: Child Protection Agreeme for Services an Office Lease between the Weld County Department of Human Services and the Pride Dialectic, LLC Enclosed for Board approval is a Child Protection Agreement for Services and Office Lease between the Department and the Pride Dialectic, LLC. This Child Protection Agreement was reviewed under the Board's Pass-Around Memorandum dated June 11, 2014, and at the Board's July 9, 2014, Work Session. The Department and Contractor will collaboratively deliver and refine P.R.I.D.E. (Peer, Respect, Initiative, Direct Education) services and evidence-informed practices and outcomes to youth between the ages of 10 and 18 who have been identified to have early gang involvement or at-risk of gang involvement. The major provisions for this Agreement are as follows: No. Contractor/Term Services/Funding Source Rates 1 PRIDE Dialectic, LLC Gang Awareness and Prevention Services Maximum Reimbursement up to July 1, 2014—June 30, 2015 CW Admin $48,050.00/year If you have any questions, please telephone me at extension 6510. 2014-2098 CHILD PROTECTION AGREEMENT FOR SERVICES BETWEEN THE WELD COUNTY DEPARTMENT OF HUMAN SERVICES AND THE PRIDE DJALECTIC, LLC This Agreement, made and entered into the?day of �UII, 2014,by and between the Board of Weld County Commissioners,on behalf of the Weld County Department of Human Services, hereinafter referred to as the"Department'and The Pride Dialectic, LLC, hereinafter referred to as the"Contractor". The parties to this Agreement understand and agree that the provisions of this Agreement specifically include the following documents: Exhibit A, Scope of Services, and Exhibit B, Payment Schedule. Each of these documents is attached hereto and incorporated herein by this reference. WITNESSETH WHEREAS,required approval,clearance,and coordination have been accomplished from and with appropriate agencies;and WHEREAS,the Colorado Department of Human Services has provided Core Services funding to the Department for Gang Prevention Services;and NOW THEREFORE,in consideration of the premises,the parties hereto covenant and agree as follows: 1. Term This agreement shall become effective on July 1,2014 upon proper execution of this Agreement and shall expire June 30, 2015 unless sooner terminated as provided herein. 2. Scope of Services Services shall be provided by the Contractor to any person(s)eligible for services in compliance with Exhibit A,Scope of Services. 3. Referrals,Billing and Tracking a. Contractor understands and will comply with all aspects of the referral authorization,billing and tracking requirements as set forth by the Department. Failure to comply with all aspects may result in a forfeiture of payment. b. Contractor agrees to receive referrals for services through e-mail and will provide an identified e-mail address prior to the start of this Agreement. Contractor acknowledges that services are not ,. authorized until the Contractor has received an authorized referral form from the Department. Contractor further acknowledges that services provided prior to the authorized start date or outside the scope of services on the referral form will not be eligible for reimbursement. Contractor acknowledges that any and all modifications to an existing referral must be approved through the Department's Resource Manager,Child Welfare Contract and Services Coordinator,or through a Team Decision Making(TDM)meeting or Family Team Meeting(FTM). No other Department staff or other party to the case may authorize services or modifications to services. 1 c. Contractor agrees to submit an itemized complete billing statement by the 7`h of the month, following the month of service,utilizing billing forms required by the Department. d. Contractor agrees to submit a monthly report with the billing statement by the 7th of the month following the month of service for each client receiving ongoing services. One-time services will be verified through receipt of the completed product(ex. psychological evaluation,substance abuse evaluation). Verification of Monitored Sobriety Services will be the test result. Contractor will document in detail any and all observed or verbalized concerns regarding any child whom the Contractor is working with under the Agreement. Areas of concern may include, but are not limited to, any physical,emotional,educational or behavioral issues. Areas of concern should be reported immediately to the caseworker AND on the required monthly report. Monthly reports will be submitted through the Department's online reporting system,unless otherwise directed or agreed to by the Department. 4. Payment a. The Department and the Contractor agree that all benefits from private insurance and/or other funding sources such as Medicaid(if Contractor is a Medicaid eligible provider)or Victim's Compensation must be exhausted before Core Services or other Department funds can be accessed for services. b. Payment shall be made in accordance with Exhibit A,Scope of Services, Exhibit B, Payment Schedule, attached hereto and incorporated herein by reference,so long as services are rendered satisfactorily and in accordance with the Agreement. c. Payment pursuant to this Agreement,whether in whole or in part, is subject to,and contingent upon, the continuing availability of said funds for the purposes hereof. d. The Department may withhold reimbursement if Contractor has failed to comply with any part of the Agreement,including the Financial Management requirements, program objectives,contractual terms,or reporting requirements. In the event of forfeiture of reimbursement,Contractor may appeal such circumstance in writing to the Director of Human Services. The decision of the Director of Human Services shall be final. 5. Financial Management At all times from the effective date of the Agreement until completion of the Agreement,Contractor shall comply with the administrative requirements,cost principles and other requirements set forth in the Financial Management Manual adopted by the State of Colorado. The required annual audit of all funds expended under this Agreement must conform to the Single Audit Act of 1984 and 0MG Circular A-133. 2 6. Payment Method Unless otherwise provided in Exhibit A, Scope of Services„ Exhibit B, Payment Schedule: a. If services are funded through Core Services,Contractor agrees to accept reimbursement through ACH direct deposit one time per month. b. If Contractor is not currently set up with the State of Colorado to accept direct deposit,Contractor agrees to complete and submit an ACH Form for Colorado Providers,which will be provided by the Department. Contractor is solely responsible to submit the ACH Form to the State of Colorado per the directions on the form. Failure to complete and submit this form in a timely and accurate manner may result in a delay of payment. c. Contractor agrees to accept payment through county warrant when funding source does not allow for direct deposit. 7. Compliance with Applicable Laws a. At all times during the performance of this Agreement,Contractor will strictly adhere to all applicable Federal and State laws,order,and applicable standards, regulations,interpretations and/or guidelines issued pursuant thereto. This includes protection of the confidentiality of all applicant/recipient records, papers,documents,tapes and any other materials that have been or may hereafter be established which relate to the Agreement. Contractor shall abide by all applicable laws and regulations,including, but not limited to the following: - Title VI of the Civil Rights Act of 1964,42 U.S.C.Sections 2000d-1 Title VI of the Civil Rights Act of 1964,42 U.S.C.Sections 2000d-1 et.seq.and its implementing regulation,45 C.F.R. Part 80 et.seq.; and - all provisions of the Civil Rights Act of 1986 so that no person shall,on the grounds of race, creed,color,sex,or national origin,be excluded from participation in,be denied the benefits of,or be otherwise subjected to discrimination under the approved Agreement. - Section 504 of the Rehabilitation Act of 1973,29 U.S.C.Section 794,and its implementing regulations,45 C.F.R. Part 84; and - the Age Discrimination Act of 1975,42 U.S.C.Section 6101 et.seq.and its implementation regulations,45 C.F.R. Part 91;and - Title VII of the Civil Rights Act of 1964; and - the Age Discrimination in Employment Act of 1967;and - the Equal Pay Act of 1963;and - the Education Amendments of 1972; and 3 - Immigration Reform and Control Act of 1986, P.L.99-603,42 C.F.R. Part 2; and - all regulations applicable to these laws prohibiting discrimination because of race,color, national origin,sex,religion,and handicap, including Acquired Immune Deficiency Syndrome (AIDS)or AIDS related conditions covered under Section 504 of the Rehabilitation Act of 1973,as amended,cited above. If necessary,Contractor and the Department will resist in judicial proceedings any efforts to obtain access to client records except as permitted by 42 C.F.R. Part 2. 45 C.F.R. Part 74,Appendix G 9,which requires that affirmative steps be taken to assure that small and minority businesses are utilized,when possible, as sources of supplies,equipment,construction and services. This assurance is given in consideration of and for the purpose of obtaining any all Federal and/or State financial assistance. - Colorado Revised Statute(C.R.S.)26-6-104, requiring criminal background record checks for all employees,contractors and sub-contractors. b. Contractor is further charged with the knowledge that any person who feels that s/he has been discriminated against has the right to file a complaint either with the Colorado Department of Human Services or with the United States Department of Health and Human Services,Office for Civil Rights. c. Contractor assures that it will fully comply with all other applicable Federal and State laws which may govern the ability of the Department to comply with the relevant funding requirements. Contractor understands the source of funds to be accessed under the Agreement is Core Services. d. Contractor assures and certifies that it and its principals: - Are not presently debarred,suspended,proposed for debarment,declared ineligible,or voluntarily excluded from covered transaction by a Federal or State department or agency; and - have not,within a three-year period preceding this Agreement, been convicted of or had a civil judgment rendered against them for commission of fraud or criminal offense in connection with obtaining,attempting to obtain,or performing a public(Federal,State or Local)transaction or contract under public transaction;violation of federal or state antitrust statutes or commission of embezzlement,theft,forgery, bribery,falsification or destruction of records, making false statements,or receiving stolen property; and - are not presently indicted for or otherwise criminally or civilly charged by a government entity(federal, state or local)with commission of any of the offenses enumerated in this certification;and - have not,within a three-year period preceding this Agreement,had one or more public transactions(federal,state,or local)terminated for cause or default. e. Contractor certifies that it shall comply with the provision of the Colorado Revised Statutes(C.R.S.)8- 17.5-101,et.seq. Contractor shall not knowingly employ or contract with an illegal alien to perform 4 work under this Agreement or enter into a contract with a subcontractor that fails to certify to the Contractor that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this Agreement. Contractor represents,warrants,and agrees that it(a)has verified that it does not employ any illegal aliens,through participation in the Basic Pilot Employment Verification Program administered by the Social Security Administration and Department of Homeland Security,and(b)otherwise will comply with the requirements of C.R.S.8-17.5-102(2)(b). Contractor shall comply with all reasonable requires made in the course of an investigation under C.R.S.8-17.5-102 by the Colorado Department of Labor and Employment. If Contractors fails to comply with any requirement of this provision or C.R.S.8-17.5-101,a seq.,the Department may terminate this Agreement for breach and Contractor shall be liable for actual and consequential damages to the Department. Except where exempted by Federal law and except as provided in C.R.S.24-76.5-103(3),if Contractor receives federal or state funds under this Agreement,Contractor must confirm that any individual natural person eighteen(18)years of age or older is lawfully present in the United States pursuant to C.R.S.24-76.5-103(4)if such individual applies for public benefits provided under this Agreement. If Contractor operates as a sole proprietor, it hereby affirms under penalty of perjury that s/he(a)is a citizen of the United States or is otherwise lawfully present in the United State Pursuant to federal law, (b)shall produce one of the forms of identification required by C.R.S.24-76.5-101,et.seq.,and (c)shall produce one of the forms of identification required by C.R.S.24-76.5-103 prior to the effective date of this Agreement. 8. Compliance with Child and Family Services Review The Child and Family Services Review(CFSR)examines child welfare service outcomes in three areas; Safety, Permanency and Well Being of families. For each outcome,data and performance indicators measure each state's performance according to national standards and monitor progress over time. Following the review,a Program Improvement Plan(PIP)will be implemented for the state to enhance services to families. Contractor agrees to continually strive for positive outcomes in the areas of Safety, Permanency and Well Being. Contractor will ensure that any employee or subcontractor of Contractor providing services under this Agreement will work towards positive outcomes in the aforementioned three areas as outlined under the Child and Family Services Review(CFSR). 9. Insurance Requirements Contractor and Department agree that Weld County,the Board of County Commissioners of Weld County, its officers and employees,shall not be held liable for injuries or damages caused by any negligent acts or omissions of the Contractor, it subcontractor,or their employees,volunteers,or agents while performing duties described in this Agreement. Contractor shall indemnify,defend and hold harmless Weld County, the Board of County Commissioners of Weld County,its employees,volunteers and agents. Contractor shall provide the liability insurances(including professional liability insurances where necessary)and worker's compensation insurances for all its employees,volunteers,and agents engaged in the performance of this Agreement which are required under Weld County's Request for Proposal,and 5 required by the Colorado Worker's Compensation Act. Contractor shall provide the Department with the acceptable evidence that such coverage is in effect within seven(7)days of the date of this Agreement. At a minimum, Contractor shall procure,either personally or through its employer as applicable to the Contractor's business,at its own expense,and maintain for the duration of the work,the following insurance coverage. Weld County,State of Colorado,by and through the Board of County Commissioners of Weld County,its employees and agents,shall be named as additional named insured on the insurance, where permissible the insurance provider. a. General Requirements:Contractors/Contract Professionals must secure,at or before the time of execution of any agreement or commencement of any work,the following insurance covering all operations,goods or services provided pursuant to this request.Contractors/Contract Professionals shall keep the required insurance coverage in force at all times during the term of the Agreement,or any extension thereof,during any warranty period, and for three(3)years after termination of the Agreement.The required insurance shall be underwritten by an insurer licensed to do business in Colorado and rated by A.M. Best Company as"A"VIII or better. Each policy shall contain a valid provision or endorsement stating"Should any of the above-described policies by canceled or should any coverage be reduced before the expiration date thereof,the issuing company shall send written notice to the Weld County Director of General Services by certified mail,return receipt requested.Such written notice shall be sent thirty(30)days prior to such cancellation or reduction unless due to non-payment of premiums for which notice shall be sent ten(10)days prior. If any policy is in excess of a deductible or self-insured retention,County must be notified by the Contractor/Contract Professional.Contractor/Contract Professional shall be responsible for the payment of any deductible or self-insured retention. County reserves the right to require Contractor/Contract Professional to provide a bond,at no cost to County,in the amount of the deductible or self-insured retention to guarantee payment of claims.The insurance coverages specified in this Agreement are the minimum requirements,and these requirements do not decrease or limit the liability of Contractor/Contract Professional.Contractor/Contract Professional shall maintain, at its own expense,any additional kinds or amounts of insurance that it may deem necessary to cover its obligations and liabilities under this Agreement. b. Types of Insurance: Contractor/Contract Professional shall obtain,and maintain at all times during the term of any Agreement,insurance in the following kinds and amounts: i. Workers'Compensation Insurance as required by state statute,and Employer's Liability Insurance covering all of Contractor's Contract Professional's employees acting within the course and scope of their employment. If Contractor is an Independent Contractor, as defined by the Colorado Worker's Compensation Act,this requirement shall not apply. Contractor must submit to the Department a Declaration of Independent Contractor Status Form prior to the start of this agreement. ii. Commercial General Liability Insurance written on ISO occurrence form CG 00 01 10/93 or equivalent,covering premises operations,fire damage, independent Contractors, products and completed operations,blanket contractual liability, personal injury, and advertising liability with minimum limits as follows: - $1,000,000 each occurrence; - $2,000,000 general aggregate; - $50,000 any one fire;and - $500,000 errors and omissions. iii. Automobile Liability: Contractor/Contract Professional shall maintain limits of $1,000,000 for bodily injury per person,$1,000,000 for bodily injury for each accident, and$1,000,000 for property damage applicable to all vehicles operating both on County property and elsewhere. 6 iv. Additional Provisions: Policies for all general liability,excess/umbrella liability, liquor liability and pollution liability must provide the following: - If any aggregate limit is reduce by twenty-five percent(25%)or more by paid or reserved claims,Contractor shall notify County within ten (10)days and reinstate the aggregates required; - Unlimited defense costs in excess of policy limits; - Contractual liability covering the indemnification provisions of this Agreement; - A severability of interests provision; - Waiver of exclusion for lawsuits by one insured against another; - A provision that coverage is primary;and - A provision that coverage is non-contributory with other coverage or self- insurance provided by County. v. For all general liability,excess/umbrella liability, liquor liability, pollution liability and professional liability policies,if the policy is a claims-made policy,the retroactive date must be on or before the contract date or the first date when any goods or services were provided to County,whichever is earlier. c. Contractors/Contract Professionals shall secure and deliver to County's Risk Administrator ("Administrator")at or before the time of execution of this Agreement,and shall keep in force at all times during the term of the Agreement as the same may be extended as herein provided,a commercial general liability insurance policy,including public liability and property damage, in form and company acceptable to and approved by said Administrator,covering all operations hereunder set forth in the related Bid or Request for Proposal. d. Proof of Insurance: Contractor/Contract Professional shall provide a copy of this information to its insurance agent or broker, and shall have its agent or broker provide proof of Contractor/Contract Professional's required insurance. County reserves the right to require Contractor/Contract Professional to provide a certificate of insurance,a policy,or other proof of insurance as required by the County's Risk Administrator in his sole discretion. e. Additional Insureds: For general liability,excess/umbrella liability, pollution legal liability,liquor liability, and inland marine,Contractor/Contract Professional's insurer shall name County as an additional insured as follows f. Waiver of Subrogation: For all coverages,Contractor/Contract Professional's insurer shall waive subrogation rights against County. g. Subcontractors: All subcontractors,subcontractors,independent contractors,sub-vendors, suppliers or other entities providing goods or services required by this Agreement shall be subject to all of the requirements herein and shall procure and maintain the same coverages required of Contractor/Contract Professional.Contractor/Contract Professional shall include all such subcontractors, independent contractors,sub-vendors suppliers or other entities as insureds under its policies or shall ensure that all subcontractors maintain the required coverages. Contractor/Contract Professional agrees to provide proof of insurance for all such subcontractors, independent contractors,sub-vendors suppliers or other entities upon request by the County. A provider of Professional Services(as defined in the Bid or RFP)shall provide the following coverage: Professional Liability: Contract Professional shall maintain limits of$1,000,000 for each claim, and $2,000,000 aggregate limit for all claims. 7 10. Certification Contractor certifies that,at the time of entering into this Agreement, it has currently in effect all necessary licenses,approvals,insurance,etc., required to properly provide the services and/or supplies covered by this Agreement. Copies of all necessary licenses shall be provided to the Department by the Contractor prior to the start of any Agreement. 11. Training Contractor is required to complete the Strengthening FamiliesTM Protective Factors Framework training online through the National Alliance of Children's Trust and Prevention Funds,as required by the Colorado Community Response,upon award of contract. Contractor may be required to attend other training at the request of the Department specific to services provided under this Agreement. The Department will not compensate the Contractor for said training in the form of registration fees,time spent traveling to and from training, attending the training or any other associated costs unless otherwise agreed to by the Department. 12. Subpoenas Contractor will,on behalf of its employees and/or officers,accept any subpoena for testimony from the Weld County Attorney's Office by e-mail and will return a waiver of services within 72 business hours. For this purpose,Contractor will designate an e-mail address prior to the start of this Agreement. If the Contractor receives a subpoena via e-mail but will only accept personal service,the Contractor will contact the Weld County Attorney's Office immediately at 970-352-1551,x6503, and advise that the subpoena must be personally served. 13. Monitoring and Evaluation Contractor and the Department agree that monitoring and evaluation of the performance of this Agreement shall be conducted by the Contractor and the Department. The results of the monitoring and evaluation shall be provided to the Board of Weld County Commissioners,the Department and the Contractor. Contractor shall permit the Department,and any other duly authorized agent or governmental agency,to monitor all activities conducted by the Contractor pursuant to the terms of this Agreement. As the monitoring agency may in its sole discretion deem necessary or appropriate,such program data,special analyses,on-site checking,formal audit examinations,or any other reasonable procedures. All such monitoring shall be performed in a manner that will not unduly interfere with the work conducted under this Agreement. 14. Modification of Agreement All modifications to this Agreement shall be in writing and signed by both parties. 8 15. Remedies The Director of Human Services or designee may exercise the following remedial actions should s/he find the Contractor substantially failed to satisfy the scope of work found in this Agreement. Substantial failure to satisfy the scope of work shall be defined to mean incorrect or improper activities or inaction by the Contractor. These remedial actions are as follows: - Withhold payment to the Contractor until the necessary services or corrections in performance are satisfactorily completed. - Deny payment or recover reimbursement for those services or deliverables,which have not been performed and which due to circumstances caused by the Contractor cannot be performed or if performed would be of no value to the Department. Denial of the amount of payment shall be reasonably related to the amount of work or deliverables lost to the Department. - Incorrect payment to the Contractor due to omission,error,fraud,and/or defalcation shall be recovered from Contractor by deduction from subsequent payments under this Agreement or other agreements between the Department and Contractor,or by the Department as a debt due to the Department or otherwise as provided by law. 16. Representatives For the purpose of this Agreement,the individuals identified below are hereby designated representatives of the respective parties. Either party may from time to time designate in writing a new or substitute representative(s). For Department: For Contractor: Heather Walker,Administrator Renee Lara,Owner 17. Notice All notices required to be given by the parties hereunder shall be given by certified or registered mail to the individuals at the addresses set forth below. Either party may from time to time designate in writing a substitute person(s)or address to whom such notices shall be sent. For Department: For Contractor: Judy A. Griego, Director Renee Lara,Owner, P.O. Box A 3424 West 6fh Street Greeley,CO 80632 Greeley,CO 80634 1970)352-1551 (970)301-2625 18. Litigation Contractor shall promptly notify the Department in the event that Contractor learns of any actual litigation in which it is a party defendant in a case that involves services provided under this Agreement. 9 Contractor,within five(5)calendar days after being served with a summons,complaint,or other pleading which has been filed in any Federal or State court or administrative agency,shall deliver copies of such document(s)to the Director of Human Services. The term "litigation"includes an assignment for the benefit of creditors,and filings of bankruptcy, reorganization and/or foreclosure. 19. Termination This Agreement may be terminated at any time by either party giving thirty(30)days written notice to the individuals identified in paragraph 18. No portion of this Agreement shall be deemed to create an obligation on the part of the County of Weld,State of Colorado,to expend funds not otherwise appropriated in each succeeding year,as this Agreement is subject to the availability of funding. Therefore,the Department may terminate this Agreement at any time if the source of funding for the services made available to the Contractor is no longer available to the Department,or for any other reason. Contractor reserves the right to suspend services to clients if funding is no longer available. 20. No Third Party Beneficiary Enforcement It is expressly understood and agreed that the enforcement of the terms and conditions of this Agreement, and all rights of action relating to such enforcement,shall be strictly reserved to the undersigned parties and nothing in this Agreement shall give or allow any claim or right of action whatsoever by any other person not included in this Agreement. It is the express intention of the undersigned parties that any entity other than the undersigned parties receiving services or benefits under this Agreement shall be an incidental beneficiary only. 21. Governmental Immunity No term or condition of this contract shall be construed or interpreted as a waiver,express or implied,of any of the immunities, rights, benefits, protections or other provisions,of the Colorado Governmental Immunity Act of§§24-10-101 et.seq. as applicable now or hereafter amended. 22. Partial Invalidity of Agreement If any section,subsection, paragraph,sentence,clause,or phrase of this Agreement is for any reason held or decided to be unconstitutional,such decision shall not affect the validity of the remaining portions. The parties hereto declare that they would have entered into this Agreement and each and every section, subsection, paragraph,sentence,clause,and phrase thereof irrespective of the fact that any one or more sections,subsections,paragraphs,sentences,clauses,or phrases might be declared to be unconstitutional or invalid. 23. Improprieties/Conflict of Interest No officer, member or employee of weld County and no member of their governing bodies shall have any pecuniary interest,direct or indirect, in the approved Agreement or the proceeds thereof. 10 The Appearance of Conflict of Interest applies to the relationship of a Contractor with the Department when the Contractor also maintains a relationship with a third party and the two relationships are in opposition. In order to create the appearance of a conflict of interest,it is not necessary for the Contractor to gain from knowledge of these opposing interests. It is only necessary that the Contractor know that the two relationships are in opposition. During the term of the Agreement, Contractor shall not enter into any third party relationship that gives the appearance of creating a conflict of interest. Upon learning of an existing appearance of a conflict of interest situation,Contractor shall submit to the Department,a full disclosure statement setting forth the details that create the appearance of a conflict of interest. Failure to promptly submit a disclosure statement required by this paragraph shall constitute grounds for the Department's termination,for cause,of its Agreement with the Contractor. Contractor certifies that Federal appropriated funds have not been paid or will be paid, by or on behalf of Contractor,to any person for influencing or attempting to influence an officer or employee of an agency, a Member of Congress,an officer or employee of Congress,or an employee of a Member of Congress in connection with the awarding of any Federal contract,the making of any Federal grant,the making of any Federal loan,the entering into of any cooperative agreement,and the extension,continuation, renewal, amendment,or modification of an Federal contract, loan,grant,or cooperative agreement. 24. Storage,Availability and Retention of Records Contractor agrees that authorized local,Federal,and State auditors and representatives shall,during business hours, have access to inspect and copy records,and shall be allowed to monitor and review through on-site visits,all activities related to this Agreement,supported with funds under this Agreement, to ensure compliance with the terms of this Agreement. Contracting parties agree that monitoring and evaluation of the performance of the Agreement shall be conducted by appropriate funding sources. The results of the monitoring and evaluation activities shall be provided to the appropriate and interested parties. All such records,documents,communications,and other materials created pursuant or related to this Agreement shall be maintained by the Contractor in a central location and shall be made available to the Department upon its request,for a period of seven(7)years from the date of final payment under this Agreement, or for such further period as may be necessary to resolve any matters which may be pending, or until an audit has been completed with the following qualifications: If an audit by or on behalf of the Federal and/or State government has begun but is not completed at the end of the seven(7)year period, or if audit findings have not been resolved after a seven(7)period,the materials shall be retained until the resolution of the audit finding. 25. Confidentiality of Records Contractor shall protect the confidentiality of all applicant records and other materials that are maintained in accordance with this Agreement except for purposes directly connected with the administration of Child Protection. No information about or obtained from any applicant/recipient in possession of Contractor shall be disclosed in a form identifiable with the applicant/recipient or a minor's parent or guardian unless in accordance with the Contractor's written policy governing access to, duplication and dissemination of,all such information,in any form, including social networks. Contractor shall advise its employees,agents,and subcontractor,if any,that they are subject to these confidentiality 11 requirements. Contractor shall provide its employees,agents,and subcontractors,if any,with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. Contractor shall have its employees, agents,and subcontractors,if any,sign a written confidentiality agreement and shall provide a copy of such agreement to the Department, if requested. 26. Proprietary Information Proprietary information for the purposes of this Agreement is information relating to a party's research, development,trade secrets, business affairs,internal operations and management procedures and those of its customers,clients or affiliates, but does not include information (1)lawfully obtained from third parties,(2)that which is in the public domain,or(3)that which is developed independently. Neither party shall use or disclose directly or indirectly without prior written authorization any proprietary information concerning the other party obtained as a result of this Agreement. Any proprietary information removed from the Department's site by the Contractor in the course of providing services under this Agreement will be accorded at least the same precautions as are employed by the Contractor for similar information in the course of its own business. 27. Independence of Contractor: Not an Employee of Weld County Contractor agrees it is an independent contractor and that its officers and employees do not become employees of Weld County, nor are they entitled to any employee benefits as Weld County employees,as the result of this Agreement. 28. Entire Agreement This Agreement,together with all attachments hereto,constitutes the entire understanding between the parties with respect to the subject matter hereof,and may not be changed or modified except as state in Paragraph 14 herein. This Agreement shall be binding upon the parties hereto,their successors, heirs, legal representatives,and assigns. The Contractor and the Department may not assign any of its rights or obligations hereunder without the prior consent of both parties. 29. Agreement Nonexclusive This Agreement does not guarantee any work nor does it create an exclusive agreement for services. 30. Warranty The Contractor warrants that services performed under this Agreement will be performed in a manner consistent with the professional standards governing such services and the provisions of this Agreement. The Contractor shall faithfully perform the work in accordance with the standards of care, skill, training, diligence and judgment provided by highly competent individuals and entities that perform services of a similar nature to those described in this Agreement including Exhibits A and B. 12 31. Acceptance of Services Not a Waiver Upon completion of the work,the Contractor shall submit to Department originals of all tests and results, reports,etc.,generated during completion of this work.Acceptance by Department of reports and incidental material(s)furnished under this Agreement shall not in any way relieve the Contractor of responsibility for the quality and accuracy of the services. In no event shall any action by the Department hereunder constitute or be construed to be a waiver by the Department of any breach of covenant or default which may then exist on the part of the Contractor,and the Department's action or inaction when any such breach or default shall exist shall not impair or prejudice any right or remedy available to the Department with respect to such breach or default;and no assent,expressed or implied,to any breach of any one or more covenants,provisions or conditions of the Agreement shall be deemed or taken to be a waiver of any other breach.Acceptance by the Department of,or payment for,any services performed under this Agreement shall not be construed as a waiver of any of the Department's rights under this Agreement or under the law generally. 32. Employee Financial Interest/Conflict of Interest.C.R.S.§424-18-201 et seq.and§24-50-507 The signatories to this Agreement aver that to their knowledge, no employee of Weld County has any personal or beneficial interest whatsoever in the service or property which is the subject matter of this Agreement.The Contractor has no interest and shall not acquire any interest direct or indirect,which would in any manner or degree with the performance of the Contractor's services and the Contractor, shall not employ any person having such known interests. During the term of this Agreement,the Contractor shall not engage in any in any business or personal activities or practices or maintain any relationships which actually conflict with or in any way appear to conflict with the full performance of its obligations under this Agreement. Failure by the Contractor to ensure compliance with this provision may result, in the Department's sole discretion,in immediate termination of this Agreement. No employee of the Contractor nor any member of the Contractor's family shall serve on a County Board,committee or hold any such position which either by rule,practice or action nominates, recommends,supervises Contract Professional's operations,or authorizes funding to the Contractor. 33. Board of County Commissioners of Weld County Approval This Agreement shall not be valid until it has been approved by the Board of County Commissioners of Weld County,Colorado. 34. Choice of Law/Jurisdiction Colorado law, and rules and regulations established pursuant thereto,shall be applied in the interpretation,execution,and enforcement of this Agreement.Any provision included or incorporated herein by reference which conflicts with said laws,rules and/or regulations shall be null and void. In the event of a legal dispute between the parties,Contract Professional agrees that the Weld County District Court shall have exclusive jurisdiction to resolve said dispute. 13 35. Attorneys Pees/Legal Costs In the event of a dispute between County and Contract Professional,concerning this Agreement,the parties agree that each party shall be responsible for the payment of attorney fees and/or legal costs incurred by or on its own behalf. • 14 IN WITNESS WHEREOF, the parties hereto have duly executed the Agreement as of the day, month, and year first above written. ATTEST: ims%) jejtotea BOARD OF COUNTY WELD COUNTY, Cs L ORADOSSIONERS Weld County Clerk to the Board O. k _ �Wt 40:-L eta Rademacher, Chair 1 Lam JUL 1 4 2014 By: De uty Clerk to the Board �•`.'. , � 1/42 soni APP AS ' sqtrs At / rcli C • ttorney WELD COUNTY DEPARTMENT PRIDE DIALECTIC, a OF HUMAN SERVICES By: • By: udy A. G ego, Dire �. Re 'ee Lara, 0 ner 15 ao& VV— O% 9� EXHIBIT A SCOPE OF SERVICES 1) Target Population Youth, between the ages of ten and eighteen,who have been identified to have early gang-involvement or at- risk of gang involvement. 2) Description of Services CONTRACTOR and Department will collaboratively deliver and refine P.R.I.D.E. (Peer Respect, Initiative, Direct Education)services and evidence-informed practices and outcomes in the areas of: a. Provide strong county-wide anti-gang education and training programs to parents, professionals and others involved with youth and families. b. Build youth resiliency and social competency through services that increase youth developmental assets,to include providing youth with training and support to learn how to deal with unsolicited gang activity. c. Collaborate with a variety of human services organizations to build support for anti-gang initiatives. d. Increase opportunities for appropriate socialization for youth through recreational and other after-school programming. e. Identify and offer positive role-modeling services and social recreational activities to engage youth in pro-social behaviors including sports/recreation, education,community service and mentoring. f. Identify a range of ongoing educational opportunities(GED,community college,work/story apprentice programs)to those at risk of school failure. g. Obtain partnerships between the community and local police departments working together to reduce the tolerance and acceptance of gangs, drugs and violence. h. Serve as a leader for surrounding communities to have access and provide training to their staff. i. Case management services including interviewing,assessing, making appropriate side-by-side home visits with existing case managers/workers,accepting the assignment of specific cases for the purposes of delivering the P.R.I.D.E.program,documenting progress of goals listed in individual family support plans and follow-up contact as indicated in Item 3b,iv. 3) Scope of Services At a minimum,the P.R.I.D.E. program,through its collaboration between Contractor and Department,will document if: a) The project successfully focused resources within the Department and Contractor to continue the P.R.I.D.E program. b) The project successfully developed a better system design to meet the needs of youth and families in regards and,at a minimum,to: i) Better utilize strengths within the family to promote protective factors. ii) increase attendance rates of youth in school. iii) 70%of youth who successfully discharge from the program will continue to reside at home and have not entered the juvenile justice system at the time of discharge. iv) Document through 30-,90-and 180-day follow-up contacts with parents that youth have not entered new systems(i.e.child welfare or DYC)since discharging from the program. 16 4) Referral Process a) Contractor will contact the Department Case Managers/Workers within 72 hours of receiving a referral for services. Contractor will meet with Case Manager/Case Worker in order to develop a brief history of the case and clarify who the participants are in the case. Contractor will describe to the Case Manager/Case Worker what services Contractor believes would be the best fit for the client and what family members should be included in the programming. b) Contractor will access all referrals through an intake interview with the family and the Case Manager/Case Worker in order to ensure that the case manager and family will commit to the necessary time resources in order to support a successful intervention. c) Contractor will meet with Case Manager Supervisor to review cases prior to final acceptance into the program. 5) Role of Department a) The Department will assign its Manager(s)to assist in the development and implementation of program and assignment of clients for Contractor. This will include screening referrals,client staffing and supervision,family support plan and performance plan approvals. b) The Department will be responsible for the identification and referral of youth and families to the P.R.I.D.E.program. c) The Department will manage monthly meetings to be held between the Contractor and the Department. d) The Department,as the Lessor,will provide office space for the first transitional year, as located at either the Weld County Department of Human Services Building at 315 North 11th Avenue,Greeley,Colorado, hereinafter referred to as"the Premises" as follows: i) The Department,as the Lessor,will provide one work space to Contractor,as Lessee,which will be located at the Premises. ii) In consideration of leasing of the aforesaid,the parties covenant and agree as follows: (1) The Department will charge no rent to Contractor for use of the office space (2) Contractor agrees to use ordinary care when using the office space; (3) Contractor may not sublet any part of the office space; (4) Contractor may not use the office space for any other purpose than conducting business and duties under the Contractor agreement; (5) Contractor shall keep the office space clean and in sanitary condition; (6) Contractor shall allow the Department any reasonable hour of the day to enter into and upon the office space. (7) Contractor shall be responsible for the loss or damage of equipment. Any time a laptop computer is assigned to a Contractor staff member,who is acting in his or her capacity as a P.R.I.D.E.worker,is lost or damaged,the situation will be assessed on a case-by-case basis with regard to whether the P.R.I.D.E.worker will be issued another laptop computer and/or whether Contractor will be required to reimburse the County for the lost or damaged equipment. (8) The Department shall pay utilities and trash removal expenses. iii) Furthermore,the parties hereto agree as follows: (1) That no assent,express or implied,to any breach of any one or more of the covenants or agreements hereof shall be deemed or taken to be a waiver or any succeeding or other breach; (2) That,to the extent permitted by law, Contractor agrees to indemnify,save and hold harmless the Department,Weld County,the Board of County Commissioners of Weld County,its employees,volunteers and agents,from any and all loss, injury,or damage whatsoever,to all office equipment,furniture,equipment,office supplies and other personal property owned by Contractor or its employees as the result of fire,flood,inclement weather,or other casualty, other than negligence of the Department; (3) The Department shall own and maintain filing cabinet s and computer systems including computers, modems, printers and associated computer equipment, used in the office space, unless provided by Contractor; 17 (4) That Contractor's employees shall escort all P.R.I.D.E.clients to and from the office space and reception area; (5) The Department shall pay for the use of the telephones and all miscellaneous office supplies used by Contractor, including photocopying for purposes of P.R.I.D.E.functions only. iv) The Department will provide training to the Contractor employee regarding the operations manual, the database,case documentation,treatment planning,community resources,team building and intervention skills. 6) Role of Contractor a) Contractor agrees to participate in the functions of the project as follows: i) As a policy and program developer and planning partner for the project by attending meetings and utilizing other forms of communication at least bi-weekly with the assigned Department Manager(s). ii) As a member of the Prevention Services Unit to enter into a Memorandum of Understanding with the Department outlining how its employees will meet the expectations of the Prevention Services Unit Operational Guidelines and to develop appropriate treatment plans for youth and families through FTE commitment by Contractor. Contractor agrees to comply with the Prevention Services Unit Operational Guidelines and participation standards through a Memorandum of Understanding through its assigned supervisor/manager and employee(s). iii) Contractor agrees to commit a full-time employee who is familiar with the Prevention Services Unit goals and the overall operational procedures of Weld County Department of Human Services policies and procedures. iv) Contractor agrees not to transport any of the youth or their families. v) Contractor agrees to screen,train and complete criminal background checks on all of their volunteer mentors who associate with youth in the P.R.I.D.E.program who meet with youth outside the presence of the family,case worker or P.R.I.D.E.employee. vi) Contractor agrees to conduct/create/implement: (1) Two(2)intensive P.R.I.D.E.28-week classes. (2) Five(5)2-hour community gang awareness trainings through the County;two(2)of which should be held in South Weld County. (3) Two(2)community-wide events to promote anti-gang message;one of which is to be held in South Weld County. (4) Four(4)school-based community programs to help reduce local gang activity;one of which is to be held in South Weld County. Each program should be at least one time per week for four(4) weeks. (5) Manage an average client caseload of 15 youth,and their families,per month,with gang activity concerns through the term of the agreement. 18 EXHIBIT B PAYMENT SCHEDULE 1. Funding and Method of Payment The Department agrees to reimburse the Contractor in consideration of the work and services performed under this Agreement at the rate specified in Paragraph 2,below. The total amount to be paid to the Contractor during the term of this Agreement shall be reported by the Department in CFMS after June 30, 2015. Expenses incurred by the Contractor prior to the term of this agreement are not eligible Department expenditures and shall not be reimbursed by the Department. Payment pursuant to this Agreement,whether in whole or in part,is subject to and contingent upon the continuing availability of said funds for the purposes hereof. In the event that said funds,or any part thereof, become unavailable as determined by the Department,the Department may immediately terminate the Agreement or amend it accordingly. 2. Fees for Services The maximum amount of reimbursement to the Contractor is$48,050.00 under the terms of this Agreement and is as follows: a. Two(2)intensive P.R.I.D.E. classes,content and length based upon curriculum,to be paid at $23.50 per hour with a maximum reimbursement rate of$4,000.00. b. Five(5) 2-hour community gang awareness trainings throughout the county;two(2)of which to be held in South County to be paid at$150.00 per training with a maximum reimbursement of $900.00. Each training must be a minimum of 2-hours in length. c. Two(2)community-wide events to promote anti-gang message;one of which to be held in South County to be paid at$500.00 per event with a maximum reimbursement of$1,000.00. d. Four(4)school-based community programs to help reduce local gang activity;one of which to be held in South County. Each program should occur once per week for four(4)weeks. The rate of pay is$500.00 per 4-week class with a maximum reimbursement of$2,000.00. e. Manage an average client caseload of 15 youth,and their families, per month,with gang activity concerns through the term of the agreement. Services will be reimbursed at$23.50 per hour up to a maximum reimbursement of$42,000.00. Contractor may not attempt to collect co-pays and/or fees for services for which a Department client is responsible, but which a particular client refuses or fails to pay. Contractor will collect any applicable sliding scale co-pays and credit the Department for any payment received on the monthly billing. 19 3. Submittal of Vouchers CONTRACTOR shall prepare and submit monthly itemized voucher and certify that services authorized were provide on the date(s) indicated and the charges made were pursuant to the terms and conditions of Exhibit A. CONTRACTOR shall submit all itemized monthly billings to the Department by the 7th day of the month following the month the cost was incurred. Failure to submit by the aforementioned deadline may result in forfeiture of payment. a. CONTRACTOR shall submit an itemized monthly bill to the Department for services provided pursuant to Exhibit A of this Agreement in accordance with criteria established by the Department. 20 Declaration of Independent Contractor Status Form We certify UNDER PENALTY OF PERJURY that:(name and trade name)qk-tlec L.V L2'ra -Tine:Pe-1/2 cctakcbc_t L-1---C performing(type of work)Zat'\ t I VTIO/.J cr. cf5 Social Security or Federal E oye dentification# 'f(i-zi58n-L, I Address: ?424(Ai lv-it4 Stags' Q retlu-I CO Ici.-7>4 Phone: fl-c)•,30/ ztc2-5 _ _ is an independent contractor(IC)and is not an employee of the following policyholder(PH): Address: Policy# Phone: We also certify,by OUR initials WHERE APPLICABLE,that the above business for which the above individual performs services meet the following criteria: 1(, ' ---PH. 1.The business DOES NOT require the individual to work ONLY for the business for whom services are performed (except that the individual may DECIDE to work only for the business for a definite period); IC 'q'PH 2.The business DOES NOT establish a quality standard for the individual (except that the business may provide plans and specifications regarding work but cannot oversee the actual work or instruct the individual as to how work will be performed); IC1a'v PH 3.The business DOES NOT pay the individual a salary or an hourly rate instead of a fixed or contract rate; 1064-KPH 4.The business DOES NOT terminate the work or the service provided during the contract period unless the individual violates the terms of the contract or fails to produce a result that meets the specifications of the contract; IC PH 5.The business DOES NOT provide more than minimal training for the individual; 1C PH_6.The business DOES NOT provide tools or benefits to the individual(except that materials and equipment may be supplied); IC(P-m PH The business DOES NOT dictate the time of performance(except that a completion schedule and a range of agreeable work hours may be established); IC/7-1"13H 8.The business DOES NOT pay the individual personally instead of making payment or checks payable to the trade or business name of the individual; ICIe4V PH 9.The business DOES NOT combine the business operations in any way with the individual's business operations instead of maintaining all such operations separately and distinctly. CERTIFICATION BY INDEPENDENT CONTRACTOR THE INDEPENDENT CONTRACTOR UNDERSTANDS THAT HEJSHE: •WILL NOT BE ENTITLED TO ANY WORKERS'COMPENSATION BENEFITS IN THE EVENT OF INJURY. •IS OBLIGATED ALL FEDERAL AND STATE INCOME TAX ON ALL MONEY EARNED WHILE PERFORMING SERVICES FOR THE BUSINE •IS RE ; �a'IDE WORKERS'COMPENSATION INSURANCE FOR ALL WORKERS THAT HEISHE HIRES. `..-. s O/25 Indepe nt cto ignature I Title Social Security# STATE O' ' ORADO,COUNTY`.O�F M�A Subscri. d • sworn before me by RtYBI. . - A<!A is day ofpi 1 Commission expires: V 51J � ' NOTARY PUBLIC ONLY KATE SHUSTER Acceptance of the Independent Contractor named ot this form d y party's retponsibllity under the Workers'Compensation Act.If individuals or organizations hired or contracted by be Indepe ot covert"by other workers'compensation insurance,the policyholder specified on this form will he charged premium for overage of rganizados. NOTARY ID 2014401247S MY C01A13SION BORES MO 1Y,20th CERTIFICATION BY BUSINESS I certify that f am authorized by the business listed above to state that all of the information on this form is true and accurate.I understand that if the above person does not qualify for independent contractor status,the proper premium can be assessed. Signature Title STATE OF COLORADO,COUNTY OF Subscribed and sworn before me by this day of Commission expires: NOTARY PUBLIC Page 2 of 2 ZAUCCIF007 R-02-06 • /..Th THEPRI-001 GRRO AI`ORO CERTIFICATE OF LIABILITY INSURANCE DATE DCfVY Y) /2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: I1 the certificate holder Is an ADDITIONAL INSURED,the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to I the terms and conditions of the polity, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTANAME:CT Wells Fargo Insurance Wells Fargo Insurance,Inc. (No,PHONENo,E„s.866-296.8458 wc,rat:866-407-7326 MAC N9306-130 E-MAIL 733 Marquette Avenue North ADDRESS:buslnesslnsuranCe@Wellifargo.com Minneapolis,MN 55402 INSURER(S)AFFORDING COVERAGE I NAICV INSURER A:Continental Casualty Company INSURED The Pride Dialectic LIc INSURER B: 3424 W 6th Street INSURER C: Greeley,CO 80634 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTMTHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ADDL,,.SUER] POLICY EFF P°L1M EIIP— ILTR TYPE OF INSURANCE INSR ?NIL POUCY NUMBER (MM/DO/MI/I IMM(DOMTY) LIMITS GENERAL UABIUTY EACH OCCURRENCE $ 'DAMAGE TU RESIT ED f COMMERCIAL GENERAL LIABILITY PREMISES(Ea manna) MED EXP(Any me person) $ CLAIMB-MADE Li OCCUR PERSONAL A ADV INJURY $ GENERAL AGGREGATE $ GEHL AGGREGATE LIMIT APPLES PER. I PRODUCTS-COMP/OP AGG I f ' I potty r r---E JECT !LOC i COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY leeFWeyd) $ ANY AUTO BODILY INJURY(Per ponce) i ALL OWNED SCHEDULED BODILY INJURY per occident) i AUTOS AUTOS NON-OWNED PROPER rY DAMAGE f HIRED AUTOS AUTOS (PeraaidanI) f UMBRELLA LAB OCCUR EACH OCCURRENCE f — EXCESS UM CLAIMS IMOEl ' .,,,,. AGGREGATE $ _ DED RETENTION f i WC STAR). 0114 AND WORKERS EMPLOYERS' . TORYLMQS I..__EB AND EMPLOYERS LIABILITY Y I N OFF PERPmMBER E CLUD(EDXECUnVE E.L.EACH ACCIDENT f (MSM RIY In N.0 E%CLUOEOr N IA IMyyeaarldwory In NNI '. E L DISEASE-EA EMPLOYEE S DESCRIPTION OF OPERATIONS telOW E L DISEASE-POLICY LIMIT $ A !Protesslonal Liability ! 596366080 7/15/2013 7/1512014 each claim/aggregate $1,000,0(X1 DESCRIPTOR OF OPERATIONS/LOCATORS I VEHICLES(Attach ACORD 101,AddM OS RAMArte Schedule,N more apace Is reeled) "'Proof of Insurance"" CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE I ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/06) The ACORD name and logo ere registered marks of ACORD I .44 O_U- JS DATE(MM/DD/YYYY) �--- CERTIFICATE OF LIABILITY INSURANCE U047 6/27/2014 THIS CERTIFICATEIS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATIONIS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT NAME: WELLS FARGO INS INC/CS/PHS NSC act, En): (866) 467-8730 Ii 01: (888) 443-6112 715154 P: (866) 467-8730 F: (888) 443-6112 PDRESS: PO BOX 29611 INSURER(S)AFFORDING COVERAGE NALCO CHARLOTTE NC 28229 INSURERA: Continental Casualty Co. INSURED INSURER B INSURER C: THE PRIDE DIALECTIC LLC INEURERD-. 3424 W 6TH ST INSURERE: GREELEY CO 80634 INSURERF• COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN.fR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY£FF POLICY EXP LIMITS ITR INSR 1WDI /MM/VD/YYVY) (MM/OD/YY1'YI • COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR $ PREMISES(Ea occurrence) MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES '.PER $ POLICY PRO- I LOC PRODUCTS•COMP/OP AGG $ JECT OTHER' $ • COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ _AUTOS (Per accident) 5 UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE 5 DEDI 'RETENTIONS WORKERS LVMPENEA PION (STATUTE I I 0TH AND EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT 5 OFFICER/MEMBER EXCLUDED? • (Mandatory In NH) N/AE.L.DISEASE-EA EMPLOYEE $ If yes,describe under E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below A Professional Liab 596346080 07/15/2014 07/15/2015 $1,000,000/$2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(AGGRO 101,Additional Remarks Schedule,may be attached B more space is required) Those usual to the Insured' s Operations. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Weld County Colorado AUTHORIZED REPRESENTATIVE 1150 O ST GREELEY, CO 80631 ®1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Hello