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HomeMy WebLinkAboutC03-047 Early and Periodic Screening Diagnosis and Treatment ProgramJanuary 23, 2003 CONTRACT CHANGE ORDER LETTER Contract Change Order Letter Number O5, Contract Routing Number 03 FAA 00693 State Fiscal Year 2002 - 2003. Early and Periodic Screenine Diagnosis and Treatment (EPSDT) Prosram This Contract Change Order Letter is issued pursuant to paragraph C. 5. of the Contract identified as contract routing number 99 FAA 00499 and contract encumbrance number PO FAA EP59900499. This Contract Change Order Letter is between the COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT and BOARD OF COUNTY COMMISSIONERS OF EAGLE COUNTY. The Contract has been amended by Contract Option to Renew Letter 01, contract routing number 00 FAA 00022, Contract Option to Renew Letter OZ, contract routing number Ol FAA 00176, Contract Option to Renew Letter 03, contract routing number 02 FAA 00103, Contract Option to Renew Letter 04, contract routing number 03 FAA 00210. andler-Contract Change Order Letter 01, contract routing number 99 FAA 01530, Contract Change Order Letter OZ, contract routing number 00 FAA 01124. Contract Change Order Letter 03, contract routing number Ol FAA 01188. and Contract Change Order Letter 04, contract routing number 02 FAA 01019, if any. The Contract, as amended, if applicable, is referred to as the "Original Contract". This Contract Change Order Letter is for the current term of March 1, 2003, through June 30.2003. The maximum amount payable by the State for the work to be performed by the Contractor during this current term is b~rease~decreased by One.Thousand Twenty Dollars, ($1,020.00) for an amended total fmancial obligation of the State of FIFTY-SIX THOUSAND FOUR HUNDRED EIGHTY-ONE DOLLARS. ($56,481.00). The revised aea~-~s~Budget e~ is incorporated herein by this reference, made a part hereof, and attached hereto as "Attachment A" and "~4ttaehn~ent *". The first sentence in paragraph C. 1. of the Original Contract is modified accordingly. All other terms and conditions of the Original Contract are reaffirmed. This change to the contract shall be effective upon approval by the State controller, or designee, or on March 1, 2003, whichever is later. Please sign, date, and return all four 4 originals of this Contract Change Order Letter by February 14, 2003, to the attention of Peesv Becker, Colorado Department of Public Health and Environment, 4300 Cherry Creek Drive South, Denver, Colorado 80246-1530, Mail Code: PSD-HCP-A4. One original of this Contract Change Order Letter will be returned to you when fully approved. BOARD OF COUNTY COMMISSIONERS OF EAGLE COUNTY (a political subdivisip~p of thg smote of By: v, Name: ' Title: Chair FEIN: 84-6000762 A' By: STATE OF COLORADO Bill Owens, Governor By: E ~ _ For the Execu a Director of FA~c DEPARTME OF PUBLIC •+ ®G HEALTH ENV11tONMENT ~ ~ ,* ~t GRAM APPROVAL: CRS 24-30-202 requires that the State Controller approve all state contracts. This contract is not valid until the State Controller, or such assistant as he may delegate, has signed it. The contractor is not authorized to begin performance until the contract is signed and dated below. If performance begins prior to the date below, the State of Colorado may not be obligated to pay for the goods and/or services provided. STATE CONTROLLER: Arthur L. Barnhart By: ,~~5,~-~ Date: 2.. ~,~ _ A 3 Rev(sed: l0/IS/OZ Page 1 of 1 • ~ ATTACHMENT A Revised 12/16/02 APPLICANT: Eagle PROJECT: EPSDT DETAILED BUDGET FOR THE PERIOD: Julv 1.2002 to June 30. 2003 Annual Number Total DIRECT COST Salary Months % Time Amount Applicant Requested EPSDT * Rate Bud et Re wired and Other from CDH PERSONNEL SERVICES: 0.35 Stone 33,797 12.00 9% 2,905 2,905 2,905 Avila 26,582 12 9% 2,326 2,326 2,326 Cuevas 25,376 12 9% 2,220 2,220 2,220 Soto 25,376 12 9% 2,220 2,220 2,220 ContractuaUFee for Service: Supervising Personnel: Sarah Schipper 68,099 12 5% 3,405 3,405 Fringe Benefits Rate = 2,901 2,901 2,901 Total Personnel Services 15,977 3,405 12,572 12,572 OPERATING EXPENSES: (includes Buflding/Facility Cost not part of Indirect) Operating 470 470 SubtotalO ratio 470 470 TRAVEL: 121 121 Subtotal Travel 121 121 EQUIPMENT: Subtotal E of ment Total Direct Costs Pers.+O ratio +Travel+E ui 16 568 3 996 12 572 12,572 AdministrativeMdirect Cost TOTAL PROJECT COST 16 568 3,996 12,572 12,572 LESS FY 03 FUNDING REDUCTION -1,020 -1,020 -1,020 TOTAL REVISED FY 03 PROJECT COST 15548 3,996 11,552 11,552 Source of Funding for "Applicant and Other" 3,996 Total A licant and Other E3,996 '"This contract will pay the actual approved rate for indirect costs finalized by the Colorado Department of Public Health and Environment and subject to the maximum rates allowed by the Prevention Services Division. The finalized rate will be retroactive to the beginning of the contract. • STATE OF COLORP,DO Bill Owens, Governor Douglas H. Benevento, F~cecutive Director Dedicated to protecting and improving the health and environment of the people of Colorado 4300 Cherry Creek Dr. S. Denver, Colorado 80248-1530 Phone (303) 692-2000 TDD Line (303) 691-7700 Looted in Glendale, Colorado http://www.cdphe.state.co.us Laboratory Services Division 8100 Lowry Blvd. Denver, Colorado 80230-6928 (303)892-3090 Maternal and Child Health Section Telephone: (303) 692-2370; FAX: (303) 782-5576 April 1, 2003 Ms. Kathleen Forinash Eagle County Health and Human Services P.O. Box 660 Eagle, Colorado 81631 RE: EPSDT FY03 Change Order Letter Dear Ms. Forinash: __„ _ - -_ :_ ~'~ oF' cow ~ti= e y 0 ~ 1876 ~` Colorado Department of public Health °• ---andEnvironment Enclosed please find a fully executed copy of the EPSDT FY03 Change Order Letter for your files. This Change Order Letter covers the period from March 1, 2003, through and including June 30, 2003. Should you have any questions please contact Lee Joseph at 303-692-2318 or lee.jo_pe hnao,state.co.us. Yours truly, ~~ Ms. Peggy Becker Contract Coordinator Maternal and Child Health Section Prevention Services Division 303-692-2404 peggy.b ecker(u~ state. co. us Enclosure I---_~~_ ' -- -- --- {~ ~~ ~h, I' , `~" fir' ~iPR ' ~ 200,E '_' P ~~~ .f~- cc: Sarah Schipper, MS, RN