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Home My WebLink About20143943.tiff * � COLORADO CO •i Office of Community Access&Independence Division of Aging 5 Adult Services December 11, 2014 Judy A. Griego, Director Weld County Department of Human Services Weld County Area Agency on Aging PO Box A 315 B North 11th Ave. Greeley, CO 80632 Dear Ms. Griego: Enclosed is your original executed Option Letter between Colorado Department of Human Services (CDHS), Division of Aging and Adult Services, and the Weld County Department of Human Services, Weld County Area Agency on Aging. This Option Letter reflects the Federal carryover funds from State Fiscal Year 2014 to State Fiscal Year 2015. The approved amount of carryover funds for State Fiscal Year 2015 was $120,044.08. Weld County Department of Human Services, Weld County Area Agency on Aging, is not required to return or sign the Option Letter. The Carry-Over Funding Request is made a part of the enclosed Option Letter. If you have any questions, please contact the Contract Program Specialist, Peggy Spaulding, at 303-866-2867 or email peqqy.spauldinq@state.co.us or me at 303-866- 2750 or email todd.coffeystate.co.us. Sincerely, Todd Coffey, Acting Director Aging & Adult Services I Enclosure cc: Eva Jewell, AAA Director, Region 2-B Peggy Spaulding, Contract Specialist SUA Master File 2014-3943 L' un 1re_ oo83 .i2-z2-iL1 OPTION LETTER Date: State Fiscal Year: Option Letter No.7 CMS Routing# i 11/5/14 2015 15 IHEA AASC 74263 1) OPTIONS: Level of service change in amount of services/goods within current term. 2) REQUIRED PROVISIONS. In accordance with Exhibit B, Paragraph N of the Original Contract routing number 12 IHA 30636 between the State of Colorado, Department of Human Services, Division of Aging and Adult Services, and Weld County, Colorado, Weld County Department of Human Services, Weld County Area Agency on Aging, the State hereby exercises its option for an increase in the amount of goods/services as specified in Exhibit E. The amount of state fiscal year 2014-2015 (SFY 2015) contract value is increased by $120,044.08 due to SFY 2014 carryover funds for a new SFY 2015 total of$1,758,035.08 as consideration for services/goods ordered under the contract. Contract price not to exceed on Page 1 of the Contract is hereby modified accordingly, as follows: Maximum amount available per fiscal year: SFY 2012 $1,197,391.00 Includes$50,253.00 in SFY 2011 Carryover Funds SFY 2012 ($90,956.33) Amount not expended in SFY 2012 SFY 2013 $1,360,078.00 Includes$92,488.00 in SFY 2012 Carryover Funds SFY 2013 ($85,412.95) Amount not expended in SFY 2013 SFY 2014 $1,451,833.00 Includes$86,699.00 in SFY 2013 Carryover Funds SFY 2015 ($118,033.02) Amount not expended in SFY 2014 SFY 2015 $1,758,035.08 Includes$120,044.08 in SFY 2014 Carryover Funds 1 The total contract value including all previous amendments, options letters, etc. is $5,472,934.78. The attached Revised Exhibit F No. 6 explains the changes to the funding during this contract period and the resulting level of funding for SFY 2015. 3) Effective Date. The effective date of this Option Letter is upon approval of the State Controller or December 1, 2014, whichever is later. STATE OF COLORADO John W. Hickenlooper, GOVERNOR Department of Human Services Reggie ch Executive Director By: Nikki Ha ch,Deputy Executive Director of Operations Date: l/- '-"l ALL CONTRACTS REQUIRE APPROVAL BY THE STATE CONTROLLER CRS §24-30-202 requires the State Controller to approve all State contracts. This Option Letter is not valid until signed and dated below by the State Controller or delegate. Contractor is not authorized to begin performance until such time. If Contractor begins performing prior thereto, the State of Colorado is not obligated to pay Contractor for such performance or for any goods and/or services provided hereunder. STATE CONTROLLER Robert Jaros, CPA, MBA, JD By: Q3mJ, L22 Clint WoodruffNalri Gimple 1 l Date: I o t _ Effective Date: Rev 5 1 13 SFY 2015 REVISED EXHIBIT F NO. 6 SFY 2015 FUNDING REQUEST TITLE III WELD COUNTY, COLORADO WELD COUNTY DEPARTMENT OF HUMAN SERVICES WELD COUNTY AREA AGENCY ON AGING REGION 2B JULY 1, 2014 TO JUNE 30, 2015 Carryover Funds Grand Total SFY Reallocated Grand Total SFY Funding Part 2015 Funds from 2015 Previous Year FEDERAL ADMINISTRATION $71,497.00 $69,778.08 $141,275.08 FEDERAL ELDER ABUSE PREVENTION $2,027.00 $18.00 $2,045.00 FEDERAL OMBUDSMAN $6,958.00 $5.00 $6,963.00 FEDERAL PART B $195,078.00 $23,982.00 $219,060.00 FEDERAL PART C-1 $273,949.00 $14,060.00 $288,009.00 FEDERAL PART C-2 $125,531.00 $2,498.00 $128,029.00 FEDERAL PART D $11,883.00 $1,286.00 $13,169.00 FEDERAL PART E $79,736.00 $8,417.00 $88,153.00 STATE ADMINISTRATION $83,928.00 $0.00 $83,928.00 STATE GENERAL FUND $755,352.00 $0.00 $755,352.00 STATE PART E MATCH $7,091.00 $0.00 $7,091.00 STATE VISUALLY IMPAIRED $24,961.00 $0.00 $24,961.00 Totals $1,637,991.00 $120,044.08 $1,758,035.08 I STATE OF COLORADO cdhs 60F•cON Ne 0, 71, } Colorado Department of Human Services a78#� people who help people OFFICE OF COMMUNITY ACCESS AND INDEPENDENCE John W Hickenlooper Viki Manley.Office Director Governor DIVISION OF AGING AND ADULT SERVICES Reggie Bicha 1575 Sherman Street,10"Floor Executive Director Denver.Colorado 80203-1714 Phone 303.886.2800 TDD 303-866-2550 FAX 303-868-2696 www Colorado 00v/Cdhs TODD COFFEY,ACTING DIRECTOR June 23, 2014 Judy A. Griego, Director Weld County Department of Human Services Weld County Area Agency on Aging 315 B North 11th Ave., PO Box A Greeley, CO 80632 Dear Ms. Griego: Enclosed is your Option Letter between Colorado Department of Human Services (CDHS), Division of Aging and Adult Services, and the Weld County Department of Human Services, Weld County Area Agency on Aging. This option letter extends your contract number 12 IHA 30636 from July 1, 2014 through June 30, 2015. Weld County Department of Human Services, Weld County Area Agency on Aging, is not required to return or sign the Option Letter. If you have any questions, please contact the Contract Program Specialist, Peggy Spaulding, at 303-866-2867 or email peacv.spauldingastate.co.us or Todd Coffey at 303-866-2750 or email todd.coffev ci.state.co.us. Sincerely, Peggy Spaulding, Contract Specialist Aging & Adult Services cc: Eva Jewell, AAA Director, Region 2-B Peggy Spaulding, Contract Specialist SUA Master File Our Miss on s to IJes gn and De giver quality Human Services that Improve the Safety and independence of the People of Colorado 1 OPTION LETTER Date: State Fiscal Year: Option Letter No.6 CMS Routing# 5/1/14 2015 15 IHEA AASC 65778 1) OPTIONS: Level of service change in conjunction with renewal for additional term 2) REQUIRED PROVISIONS. In accordance with Exhibit B, Paragraph N of the Original Contract routing number 12 IHA 30636 between the State of Colorado, Department of Human Services, Division of Aging and Adult Services, and Weld County, Colorado, Weld County Department of Human Services, Weld County Area Agency on Aging, the State hereby exercises its option for an additional term beginning July 1, 2014 and ending on June 30, 2015 and an increase in the amount of goods/services. The amount of state fiscal year 2014-15 (SFY 2015) contract value shall be $1,637,991.00 for a new total contract value of $5,470,923.72 as consideration for services/goods ordered under the contract for SFY 2015. Contract price not to exceed at Page 1 of the Contract is hereby modified accordingly, as follows: Maximum amount available per fiscal year: SFY 2012 $1,197,391.00 Includes $50,253.00 in SFY 2011 Carryover Funds SFY 2012 ($90,956.33) Amount not expended in SFY 2012 SFY 2013 $1,360,078.00 Includes$92,488.00 in SFY 2012 Carryover Funds SFY 2013 ($85,412.95) Amount not expended in SFY 2013 SFY 2014 $1,451,833.00 Includes$86,699.00 in SFY 2013 Carryover Funds SFY 2015 $1,637,991.00 The total contract value including all previous amendments, options letters, etc. is $5,470,923.72. The attached Revised Exhibit F No 5 explains the changes to the funding during this contract period and the resulting level of funding for SFY 2015 3) Effective Date. The effective date of this Option Letter is upon approval of the State Controller or July 1, 2014, whichever is later. STATE OF COLORADO John W. Hickenlooper, GOVERNOR Department of Human Services Reggie , xecutiive Director By: Nikki Hatch, Deputy Executive Director of Operations Date: 5. 21./4( ALL CONTRACTS REQUIRE APPROVAL BY THE STATE CONTROLLER CRS §24-30-202 requires the State Controller to approve all State contracts. This Option Letter is not valid until signed and dated below by the State Controller or delegate. Contractor is not authorized to begin performance until such time. If Contractor begins performing prior thereto, the State of Colorado is not obligated to pay Contractor for such erformance or for any goods and/or services provided hereunder. STATE CONTROLLER Robert Jaros, CP , MBA,JD By: (b., jp CLIWT WOODRUFF Date: Effective Date Rev 5 1 13 SFY 2015 REVISED EXHIBIT F NO. 5 SFY 2015 FUNDING REQUEST TITLE III WELD COUNTY, COLORADO WELD COUNTY DEPARTMENT OF HUMAN SERVICES WELD COUNTY AREA AGENCY ON AGING REGION 2B JULY 1, 2014 TO JUNE 30, 2015 ;Funding Transfers and/or Carryover Funds New Funds Reallocated Funding Part Prior to Amount New Funds Grand Total Transferred After Transfers Funds from SFY 2015 Transfers Previous Year FEDERAL ADMINISTRATION $71,497.00 - $71,497.00 $71,497.00 FEDERAL ELDER ABUSE PREV. $1,855.00 - $1,855.00 $172.00 $2,027.00 FEDERAL OMBUDSMAN $6,880.00 - $6,880.00 $78.00 $6,958.00 FEDERAL PART B $180,639.00 $13,606.00 $194,245.00 $833.00 $195,078.00 FEDERAL PART C-1 $271,653.00 - $271,653.00 $2,296.00 $273,949.00 FEDERAL PART C-2 $138,558.00 ($13,606.00) $124,952.00 $579.00 $125,531.00 FEDERAL PART D $11,834.00 - $11,834.00 $49.00 $11,883.00 FEDERAL PART E $79,360.00 - $79,360.00 $376.00 $79,736.00 STATE ADMINISTRATION $83,928.00 - $83,928.00 $83,928.00 STATE GENERAL FUND $755,352.00 - $755,352.00 - $755,352.00 STATE PART E MATCH $7,091.00 - $7,091.00 - $7,091.00 STATE VISUALLY IMPAIRED $24,961.00 - $24,961.00 - $24,961.00 Totals $1,633,608.00 - $1,633,608.00 $4,383.00 $1,637,991.00 Page 1 of 1 STATE OF COLORADO cdis +e �o Colorado Department of Human Services people who help people OFFICE OF LONG TERM CARE John W.Hickenlooper Viki Manley,Office Director Governor DIVISION OF AGING AND ADULT SERVICES Reggie Bicha 1575 Sherman Street,10'"Floor Executive Director Denver,Colorado 80263-1714 Phone:303-866-2800 TDD 303-866-2550 FAX 303-866-2696 www.colorado qqv/cdhs December 4, 2013 Judy A. Griego, Director Weld County Department of Human Services Weld County Area Agency on Aging 315 B North 11th Ave. PO Box A Greeley, CO 80632 Dear Ms. Griego: Enclosed is your original executed Option Letter between Colorado Department of Human Services (CDHS), Division of Aging and Adult Services, and the Weld County Department of Human Services, Weld County Area Agency on Aging. This Option Letter reflects the Federal carryover funds from State Fiscal Year 2013 to State Fiscal Year 2014. The approved amount of carryover funds for State Fiscal Year 2014 was $86,699.00. Weld County Department of Human Services, Weld County Area Agency on Aging is not required to return or sign the Option Letter. The Carry-Over Funding Request was received, reviewed, and approved by the State Unit on Agency and made a part of the enclosed Option Letter. If you have any questions, please contact the Contract Program Specialist, Peggy Spaulding, at 303-866-2867 or email peggy.spaulding@state.co.us or me at 303-866-2750 or email todd.coffevgstate.co.us. Sincere) , Todd Coffey, Acting Director Aging & Adult Services cc: Eva Jewell, AAA Director, Region 2B Peggy Spaulding, Contract Specialist SUA Master File Our Mission is to Design and Deliver Quality Human Services that Improve the Safety and Inaependence of the People of Colorado OPTION LETTER Date: State Fiscal Year: Option Letter No. 5 CMS Routing# 11/1/13 2014 14 IHA 61056 1) OPTIONS: Level of service change in amount of services/goods within current term. 2) REQUIRED PROVISIONS: In accordance with Exhibit B, Paragraph N of the Original Contract routing number 12 IHA 30636 between the State of Colorado, Department of Human Services, Division of Aging and Adult Services, and Weld County, Colorado, Weld County Department of Human Services, Weld County Area Agency on Aging, the State hereby exercises its option for an increase in the amount of goods/services as specified in Exhibit E. The amount of state fiscal year 2013-2014 (SFY 2014) contract value is increased by $86,699.00 from SFY 2013 carryover funds for a new total contract value of $1,451,833.00 as consideration for services/goods ordered under the contract for SFY 2014. Contract price not to exceed at Page 1 of the Contract is hereby modified accordingly, as follows: Maximum amount available per fiscal year: SFY 2012 $1,197,391.00 Includes $50,253.00 in SFY 2011 Carryover Funds SFY 2012 ($90,956.33) Amount not expended in SFY 2012 SFY 2013 $1,360,078.00 Includes$92,488.00 in SFY 2012 Carryover Funds SFY 2013 ($85,412.95) Amount not expended in SFY 2013 SFY 2014 $1,451,833.00 Includes$86,699.00 in SFY 2013 Carryover Funds The total contract value including all previous amendments, options letters, etc. is$3,832,932.72. The attached Revised Exhibit F No. 4 explains the changes to the funding during this contract period and the resulting level of funding for SFY 2014. 3) Effective Date. The effective date of this Option Letter is upon approval of the State Controller or November 22, 2013, whichever is later. STATE OF COLORADO John W. Hickenlooper, GOVERNOR Department of Human Services Re Bi Executive Director By: Nikki atch, Deputy Executive Director of Operations Date: � /1 / 3 ALL CONTRACTS REQUIRE APPROVAL BY THE STATE CONTROLLER CRS §24-30-202 requires the State Controller to approve all State contracts. This Option Letter is not valid until signed and dated below by the State Controller or delegate. Contractor is not authorized to begin performance until such time. If Contractor begins performing prior thereto, the State of Colorado is not obligated to pay • Contractor for such performance or for any goods and/or services provided hereunder. STATE CONTROLLER Robert Jaros, CPA, MBA, JD By: aZeG,/,,reZZ-1' Date: / .47/oal/cg Effective Date: Rev 5 1 '13 SFY 2014 REVISED EXHIBIT F NO. 4 SFY 2014 FUNDING REQUEST TITLE III & TITLE VI WELD COUNTY, COLORADO WELD COUNTY DEPARTMENT OF HUMAN SERVICES WELD COUNTY AREA AGENCY ON AGING REGION 2B JULY 1, 2013 TO JUNE 30, 2014 Funding Amounts: Funding Part Beginning SFY Added Carryover Total Funds Available for 2014 Budget Funds SFY 2014 TITLE III-Part B,C1,C2&D S 570,869.00 S 35,105.00 $ 605,974.00 Title II Part E&State E Match S 85,258.00 $ 6,820.00 $ 92,078.00 Federal Admin $ 67572.00 S 44,668.00 $ 112,240.00 TITLE VII-EA&OMB $ 6,936.00 S 106.00 S 9,042.00 State Cash Services&Admin S 632,499.00 S - $ 632,499.00 Total $ 1,365,134.00 $ 86,699.00 $ 1,451,833.00 Detailed Explanation of SFY and Cummulative Funding Amounts: SFY Adjusted Funding Contacts,Option Explanation Amounts SF Y Funding Amount based on Cumulative Letters,AdjustmentsAmount Expenditures and Funding Amount Carryovers New Contract SFY 2012 Orglnal Contract $ 1,147,138.00 $ 1,147,138.00 $ 1,147,138.00 $ 1,147,138.00 Option Letter 1 Amount Carried Over from Prior Contract and $ 50,253.00 $ 1,197,391.00 $ 1,197,391.00 $ 1,197,391.00 J1•fustment for Actual Federal Amounts Option Letter 2 SPY 2013 New Allocation Amount not Expended In SFY 2012 $ 1,267,590.00 $ 1,267,590.00 $ 1,267,590.00 $ 2,464,981.00 Adjustment $ (90,956.33) $ 1,267,590.00 $ 1,176,633.67 $ 2,374,024.67 Option Letter 3 Carryover Allocated from SFY 2012 $ 92,488.00 $ 1,360,078.00 $ 1,269,121.67 $ 2,466,512.67 Option Letter 4 SPY 2014 New Allocation $ 1,365,134.00 $ 1,365,134.00 $ 1,365,134.00 $ 3,833,646.67 Adjustment Amount not Expended In SFY 2013 ; (85,412.95) S 1,365,134.00 S 1,279,721.05 $ 3,746,233.72 Option Letter 5 SFY 2014 New Allocation I $ 86,699.00 $ 1,451,833.00 $ 1,451,833.00 $ 3,832,932.72 I 0 STATE OF COLORADO cdhs pF c0,„ �e ,d* ., F' Colorado Department of Human Services * '' *1876` people who help people OFFICE OF LONG TERM CARE John W.Hickenlooper Joscelyn Gay,Office Director Governor DIVISION OF AGING AND ADULT SERVICES Reggie Bicha 1575 Sherman Street,10,v Floor Executive Director Denver,Colorado 80203-1714 Phone.303-866-2800 TDD 303-866.2550 FAX 303.866-2696 www colorado.00v/cdhs December 27, 2012 Judy A. Griego, Director Weld County Department of Human Services Weld County Area Agency on Aging 315 B North 11th Ave., PO Box A Greeley, CO 80632 Dear Ms. Griego: Enclosed is your original executed Option Letter between Colorado Department of Human Services (CDHS), Division of Aging and Adult Services, and the Weld County Department of Human Services, Weld County Area Agency on Aging. This Option Letter reflects the Federal carryover funds from State Fiscal Year 2012 to State Fiscal Year 2013. The approved amount of carryover funds for State Fiscal Year 2013 was $92,488.00. Weld County Department of Human Services, Weld County Area Agency on Aging is not required to return or sign the Option Letter. The Carryover Funding Request was received, reviewed, and approved by the State Unit on Agency and made a part of the enclosed Option Letter. If you have any questions, please contact the Contract Program Specialist, Peggy Spaulding, at 303-866-2867 or email peooy.spauldinostate.co.us or me at 303-866-2750 or email todd.coffev( state.co.us. Sincerely, odd Coffey, Acting Director Aging & Adult Services cc: Eva Jewell, AAA Director, Region 2-B Peggy Spaulding, Contract Specialist SUA Master File Our Mission s to Design and Deliver Quality Human Services that Improve the Safety and Independence of the People of Colorado OPTION LETTER Date: 11/09/12 State Fiscal Year: 2013 Option Letter No. 3 J CMS Routing#13 IHA 50341 1)OPTIONS: Change in the amount of services/goods within current term. 2) REQUIRED PROVISIONS. In accordance with Exhibit B, Paragraph N of the Original Contract routing number 12 IHA 30636 between the State of Colorado, Department of Human Services, and Weld County, Colorado Weld County Department of Human Services, Weld County Area Agency on Aging, the State hereby exercises its option for an increase in the amount of goods/services at the same rate(s) as specified in Exhibit D. The amount of state fiscal year 2012-13 (SFY 13) contract value is increased by $92,488.00 from SFY12 carryover funds for a new SFY 13 contract value of $1,360,078.00 as consideration for services/goods ordered under the contract for SFY 13. The Contract price not to exceed at Page 1 of the Contract is hereby modified accordingly, as follows: Maximum amount available per fiscal year. SFY 12: $1,197,391.00 SFY 13: $1,360,078.00 includes$92,488.00 in carryover funds The total contract value including all previous amendments, options letters, etc. is $2,557,469.00. The attached Revised Exhibit F No. 2 funding document shall apply to said increase in services/goods for SFY 13. 3) Effective Date. The effective date of this Option Letter is upon approval of the State Controller or December 1, 2012, whichever is later. STATE OF COLORADO John W. Hickenlooper, GOVERNOR Department of Human Services Re Executive Director By: Nikki Hatch, Deputy Executive Director of Operations Date: /2//3//2'- 1 ALL CONTRACTS REQUIRE APPROVAL BY TAE STATE CONTROLLER CRS§24-30-202 requires the State Controller to approve all State Contracts.This Contract is not valid until signed and dated below by the State Controller or delegate. Contractor is not authorized to begin performance until such time. If Contractor begins performing prior thereto,the State of Colorado is not obligated to pay Contractor for such performance or for any goods and/or services provided hereunder. STATE CONTROLLER Da J. McDe ott CPA CLINT WOODRUFF By: Date: Effective Date: 1/6/09-Rev 8/25/09 SFY 2013 REVISED EXHIBIT F NO. 2 SFY 2013 CARRYOVER FUNDING REQUEST TITLE III WELD COUNTY,COLORADO,WELD COUNTY DEPARTMENT OF HUMAN SERVICES WELD COUNTY AREA AGENCY ON AGING REGION 2B JULY 1,2012 TO JUNE 30,2013 ADMIN&TITLE III ADMINISTRATION INITIAL BUDGET CARRYOVER FUNDS TOTAL BUDGET ADMINISTRATION $ 75.365 $ 25.429 $ 100,794 TOTAL ADMIN $ 75,385 $ 25,429 S 1,"794 SERVICES INITIAL BUDGET CARRYOVER FUNDS TOTAL.BUDGET PART B $ 280,402 $ 27,834 S 308,236 PART Cl S 310,459 $ 29,173 S 339,632 PART C2 $ 41,000 $ 468 $ 41,468 PART D S 12,954 $ 1,296 $ 14,250 PART E S 83,479 $ 8,266 S 91,745 TOTAL SERVICES S 728,294 S 87,037 $ 795,331 TITLE VII INITIAL BUDGET CARRYOVER FUNDS TOTAL BUDGET EAP $ 2,088 S $ 2,088 LTC OMB $ 7,305 S 22 S 7,327 TOTAL TITLE VII $ 9,393 $ 22 S 9,415 SUMMARY OF ADMIN,TITLE III,TITLE VII AND STATE FUNDING FOR SENIOR SERVICES BUDGETS INITIAL BUDGET CARRYOVER FUNDS TOTAL BUDGET IADMIN,TITLE III&TITLE VII TOTAL 9 813,052 $ 92,488 $ 905,540 INITIAL BUDGET CARRYOVER FUNDS TOTAL BUDGET STATE FUNDS TOTAL S 402,594 S S 402,594 STATE ADMINISTRATIVE FUNDS TOTAL S 44,733 S S 44,733 NATL.FAMILY CAREGIVER(GENERAL FUND)TOTAL S 7,211 $ - S 7,211 STATE FUNDING FOR SENIOR SERVICES TOTAL S 454,538 $ - $ 454 8 STATE OF COLORADO cdis Colorado Department of Human Services *�,X876 * people who help people . OFFICE OF LONG TERM CARE John W Hictcenlooper Joscelyn Gay,Office Director Governor DIVISION OF AGING AND ADULT SERVICES Regg e B;cha 1575 Sherman Street,10"Floor Executive Director Denver,Colorado 60203-1714 Phone:303-866-2600 TDD 303-866-2550 FAX 303-866.2696 www coloradQgovicdh$ June 27, 2012 Judy A. Griego, Director Weld County Department of Human Services Weld County Area Agency on Aging 315 B North 11th Ave., PO Box A Greeley, CO 80632 Dear Ms. Griego: Enclosed is your original executed Option Letter between Colorado Department of Human Services (CDHS), Division of Aging and Adult Services, and the Weld County Department of Human Services, Weld County Area Agency on Aging. This option letter extends your contract 12 IHA 30636 from July 1, 2012 through June 30, 2013. Weld County Department of Human Services, Weld County Area Agency on Aging is not required to return or sign the Option Letter. If you have any questions, please contact the Contract Program Specialist, Peggy Spaulding, at 303- 866-2867 or email peqqy.spauldinq( state.co.us or me at 303-866-2750 or email todd.coffer@state.co.us. Sincerely, Todd Coffey, Acting Director Aging & Adult Services cc: Eva Jewell, AAA Director, Region 2-B Peggy Spaulding, Contract Specialist SUA Master File Our Mission is to Design and Deliver Quality Human Services that Improve the Safety and Independence of the People of Colorado OPTION LETTER Date T State Fiscal Year: 2013 1 Option Letter No. 2 CMS Routing May 25, 2012 #13 IHA 41643 1) OPTIONS: Change in amount of services/goods in conjunction with renewal for additional term. 2) REQUIRED PROVISIONS. In accordance with Exhibit B, Paragraph N of the Original Contract routing number 12 IHA 30636 between the State of Colorado, Department of Human Services, Division of Aging and Adult Services, and Weld County, Colorado, Weld County Department of Human Services, Weld County Area Agency on Aging, the State hereby exercises its option for an additional term beginning July 1, 2012 and ending on June 30, 2013 AND an increase in the amount of goods/services The amount of state fiscal year 2013 (SFY 2013) contract value shall be $1,267,590.00 as consideration for services/goods ordered under the contract for SFY 2013. The total contract value including all previous amendments, options letters, etc. is$2,464,981.00 (State Fiscal Year 2013 $1,267,590.00; State Fiscal Year 2012 $1,197,391.00). The Contract Price provision at Page 1 of the Contract is herby modified accordingly. The attached Revised Exhibit F funding document shall apply to said increase in goods/services for state fiscal year 2013. 3) Effective Date. The effective date of this Option Letter is upon approval of the State Controller or July 1, 2012, whichever is later. STATE OF COLORADO John W. Hickenlooper,GOVERNOR Depa ment of Human Services Re , Ex ive Director y: Nikki Hatch, ep Executive Director Date: 1p ! �Z ALL CONTRACTS REQUIRE APPROVAL BY THE STATE CONTROLLER CRS§24-30-202 requires the State Controller to approve all State Contracts.This Contract is not valid until signed and dated below by the State Controller or delegate. Contractor is not authorized to begin performance until such time. If Contractor begins performing prior thereto,the State of Colorado is not obligated to pay Contractor for such performance or for any goods and/or services provided hereunder. STATE CONTROLLER David �JJ..�McDermott,CPA By fiat, VALfI Date: �.? ,�i/y 7 Effective Date:1/6/09-Rev 6/25/09 SFY 2013 REVISED EXHIBIT F 2013 TITLE III FUNDING REQUEST Region 2B Funding# 02B-88 Revision# 1 Date 7/1/2012 Funding Request Period: from July 1,2012 through June 30,2013 Add this FY Percentages for Admin Distribution: B C1 C2 E Total 30.77% 37.80% 19.05% 12.38% 100.00% ADMINISTRATION Potential Funding Transfer Request Funding Request Admin Reallocated $ - $ - ADMIN NEW ALLOC $ 75,365 $ - $ 75,365 TOTAL ADMIN $ 75,365 $ - $ 75,365 SERVICES REALLOCATED $ 752 $ 752 PART B NEW ALLOC $ 220,824 $ 58,826 $ 279,650 REALLOCATED $ 824 $ 824 PART C1 NEW ALLOC $ 271,777 $ 37 858 $ 309,635 REALLOCATED $ 291 $ 291 PART C2 NEW ALLOC $ 137,393 $ 96,684 $ 40,709 REALLOCATED $ - $ - PART D NEW ALLOC $ 12,954 $ 12,954 REALLOCATED $ 189 $ 189 PART E NEW ALLOC $ 83,290 $ 83,290 TOTAL SVC CARRYOVER $ 2,056 $ 2,056 TOTAL SVC.NEW ALLOC $ 726,238 $ 726,238 TOTAL SERVICES $ 728,294 $ - $ 728,294 Title VII Funding Request Total Programmatic Programmatic Fundin• Transfer Total EAP REALLOCATED $ 23 $ 23 EAP NEW ALLOC $ 2,065 $ - $ 2,065 LTC OMB REALLOCATED $ 49 $ 49 LTC OMB NEW ALLOC $ 7,256 $ - $ 7,256 TOTAL TITLE VII $ 9,393 $ - $ 9,393 Annual Funding Request(AAS 200) Region 28 Fiscal Year 2013 Revision # 1 Date 7/1/2012 AREA AGENCY ADMINISTRATION BUDGET Line Item Budget Federal Budget Local Cash Budget In-Kind Budget Total Budget Personnel $ 63,565 $ - $ 25,122 $ 88,687 Travel $ - $ - $ - $ - Equipment $ - $ - $ - $ - Other Direct $ 7,300 $ - $ - $ 7,300 Indirect $ 4,500 $ - $ - $ 4,500 Total $ 75,365 $ - $ 25,122 $ 100,487 Total Admin from AAS 200 * Match must be 25 of total budget: (Match = Local Cash Budget+ In-Kind budget) Federal Funds= $ 75,365.00 / 3 = T 25,122.00 This is the minimum match required. Actual Match = $ 25,122.00 Over/(Under) Match $ - Annual Funding Request (AAS 220) Weld County Area Agency On Aging Northern Region State Funding Request: State Fiscal Year: 2013 Total Budget Total Revised State Funding For Senior Services: (SFSS) Award Move Budget AVAILABLE SERVICE FUNDS $402,594 $0 $402,594 • AVAILABLE ADMINISTRATIVE FUNDS $44,733 $Q $44,733 1 National Famil Care•iver General Fund Match * $7,211 $7,211 TOTAL: $454,538 $0 $454,538 Certifications and Assurances: Agree A) National Family Caregiver (General Fund Match) is to be used as service dollar match related to National Family Caregiver services. - (This is match only; not State Funds used as identified and budgeted under the'Caregiver Budget'tab.) B) Low Income/Minority individuals will be targeted in compliance with Title III rules. [J C) All state funds will be fully expended within the State Fiscal Year ending June 30th. D) Other than the National Family Caregiver State match, all state funds will be used as overmatch funds and will increase service units and clients served to the over all Senior Services Programs. E) All services provided will meet the program and fiscal requirements in CDHS Volume 10, [] except the CDHS 10.240 11(B) priority services: Access, In-Home Services and Legal Services. Director Signature. Date: Hello