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HomeMy WebLinkAboutC04-314 Colorado Department of Public Health and Environment – Bioterrorism Grant~o~ -~3i~-ate.
STATE OF COLORADO
Bill Owens, Governor
Douglas H. Benevento, Executive Director
Dedicated to protecting and improving the health and environment of the people of Colorado
4300 Cherry Creek Dr. S. Laboratory Services Division ~ _ __
Denver, Colorado 80246-1530 8100 Lowry Blvd. ~ .~
Phone (303) 692-2000 Denver, Colorado 80230-6928 1 . s -~ _. . , f
TDD Line (303) 691-7700 (303) 692-3090
Located in Glendale, Colorado ~~ ~} ~ ~ ~Q~~
http://www.cdphe.state.co. us
September 8, 2004
Dear Local Health Partner,
HEALTc~ & ~`~U~y~r;~v ~iri-~4~;w..a
.t`v --
~~
of Coto
H
~ ~8~s ~
Colorado Department
of public Health
and Environment
Enclosed please find a fully approved Purchase Order (OE FHA EPI05000094) between the State of Colorado, Department of
Public Health and Environment's Preparedness Programs and Eagle County Government for the use and benefit of Eagle County
Nursing Service. This purchase agreement references your Bioterrorism Grant Year 04/05 Preparedness & Response Activities
Scope of Work and has an effective start date of September 1, 2004. Please keep this original in your contracts file
For your information and the reference of your auditors, the United State Department of Health and Human Service, Centers for
Disease Control and Preventions ("CDC") has awarded the State these federal funds under Notice of Cooperative Agreement
Award ("NCAA") number U90/CCU816827-05-O1 to fund "Public Health Preparedness and Response for Bioterrorism"
activities, see, Catalog of Federal Domestic Assistance ("CFDA") number 93.283.
Please review the attached document(s) and upon review and approval please sign below and then fax this signed letter to the
attention of Marti Wood at (303) 691-7811 by October 15, 2004.
After faxing the signed letter to my attention, you may begin submitting invoices for reimbursement of any expenses incurred
during this grant award period. Please duect those billings and any questions you might have regarding the reimbursement process
to the attention of Brian Hancock, Contracts Monitor for the Public Health Preparedness Programs at (303) 692-2681. (A copy of
the billing form is also attached.)
As always thank you for your continued cooperation and support. Should you have any questions or require further information
please do not hesitate to contact me.
Sincerely,
Marti Wood
Contracts Coordinator
Public Health Preparedness Programs
Colorado Department of Public Health and Environment
Phone: (303) 692-2645
Fax: (303) 691-7811
LOCAL HEALTH PARTNER ACCEPTANCE OF PURCHASE ORDER
I, , on behalf of ,hereby acknowledge that
the Scope of Work and Purchase Agreement have been reviewed, and are accepted and agreed to. I further
acknowledge that I have the necessary authority to sign this acceptance on behalf of the entity mentioned
above.
~ ~81~~
Date
CO DEPT OF PUBLIC HEALTH/ENV
4300 CHERRY CREEK DRIVE SO
DENVER CO 80246 1530
Buyer. LUPE QUESADA
Phone Number: 303-692-2073
Agency Contact: MARTI WOOD
' Phone Number: 303 692 2645
DATE: 09-01-04 oF•~o
,~~
._; -`°.~
PURCHASE
.
~
y4~ :.
ORDER
IMPORTANT
The PO # and Line # must * *
# >r STATE OF COLORADO
appear on all invoices, ~ 1876 ~`
packing slips, cartons P.O. # OE FHA EP105000094 Page# O1
and correspondence
ACC : 0 8 - 31- 0 4 State Award #
FEIN 846000762 L Phone: - -
Vendor Contact:
Purchase Requisition #: R% FHA EP105000144
e EAGLE COUNTY GOVERNMENT
N EAGLE COUNTY NURSING SERVICE
o PO BO% 660
R EAGLE CO 81631
INSTRUCTIONS TO VENDOR:
1. It for any nmson, dellwry of this older la oelayed beydtd the dellwryllnstallaUOn date
shown, plgp nolly the agency rnMaet named at tM top IeR (Right of ancNlatlon Is
reserved In Instanps In whkh Umey dNlwry Is not made.)
2. All ehemkals, equlpneM and materleb must coMOrm to the sMndards rcqulred ty OSHA.
3. NOTE: Addttbnel terms aM eondttlons on nwrse side.
SPECIAL INSTRUCTIONS:
Bid #
Invoice in Triplicate
To: DEPT PUBLIC HEALTH/ENVIRONMENT
DIS CONTRQL&ENV EPI DIV A-3
4300 CHERRY CREEK DRIVE SOUTH
DENVER, COLORADO 80246-1530
Payment will be made by this agency
Ship CO PUBLIC HEALTH/ENVIRONMENT
To: DIS CNTL & ENV EPI DIV A-3
4300 CHERRY CREEK DRIVE SOUTH
DENVER CO 80246 1530
Delivery/Installation Date: 08-31-05
F.O.B. T17. CT1T hT 7\TTf1LT CST 71 rTL~ T1A
LINE COMMODITYIITEM UNIT OF pUANTITY UNIT COST TOTAL ITEM COST
ITEM CODE MEASUREMENT
001 91883000000 $39,451.00
BT GRANT YEAR 04/05 PREPAREDNESS & RESPONSE ACTIVITIES
SOW INCORPORATED HEREIN BY REFERENCE TERM: 09/01/04-08/31/05
THIS PO IS ISSUED IN ACCORDANCE WITH STATE AND FEDERAL REGULATIONS
FPO FM
DOCUMENT TOTAL = $39,451.00
/'/~E STATE ~ COLORADO
~~ _ r ~~
AutlarizW Signature
Eagle County Public Health Nursing Service
2004-2005 Scope of Work
Public Health Preparedness and Response
Program Activities
Contract Term: September 1, 2004 through August 31, 2005
Contract Objective: To ensure statewide coordination in preparedness and response to bioterrorism, outbreaks of
infectious disease, other public health threats and emergencies. To maintain and enhance statewide capacity in the
following areas: emergency preparedness and response; integrated detection and investigation; prevention;
laboratory readiness; sustaining competent and trained workers; research and evaluation; communications as well
as integrated and secure information systems. Contractor shall achieve these objectives through state, regional and
local partnerships.
Contractor shall ensure collaboration with all regional staff within the North West Region, including: Eagle,
Garfield, Grand, Jackson, Mesa, Moffat, Pitkin, Rio Blanco, Routt, and Summit counties. Contractor shall be
responsible for fulfilling the contracted responsibilities and ensuring agency representation at required meetings,
training sessions, and conference calls. Contractor shall designate at least one staff member as the point of contact
for public information, communications, or media relations. Contractor shall be responsible for required agency
progress reports. Contractor shall be responsible for appropriate use of grant funds for all staff working on related
projects as well as required equipment, supplies, travel, and operating expenses. Contractor shall at no time utilize
grant funds to supplant other programs or unrelated projects.
Project Area 1: Plannins 8c Response Foundation: In conjunction with public health and emergency response
partners, assess resources, infrastructure, and capacities to respond to an emergency and develop, update,
evaluate, and revise scalable plans that facilitate response.
In order to achieve the above objective and reach *hP dPC1Qn9+Pd manotr...n~ ......a....~a,._ ..L,.n
-- '- - - -- ---- -- ..v, ~. a
Activities /Tasks (1v1V1 JLllll•
Associated
Milestones
Completion
Date s
1.Collaborate with Regional Staff to provide information on local resources for 1.6, 1.10 9/1104-8/31/05
res once laps, includin SNS, Communication, and Disease Investi ation
2. Attend two bi-re Tonal Tannin meetin s 1.1 9/1/04-8/31/05
3. Review and update, as necessary, agency emergency response plan, agency 1.2, 1.3, 1.4, 1.5, 9/1/04-8/31/05
res irato rotection Tan, disease investi ation rotocols, and mass clinic laps. 3.1, 3.2,
4. Partici ate in coon -level inters enc Tannin efforts 1.1, 1.10 9/1/04-8/31/05
5. In collaboration with regional staff and as necessary, assist and participate in the 1.7, 1.8, 1.9 9/1/04-8/31/05
following: mass fatality planning; ensuring that all staff are aware of and understand
the Public Health statutes and their respective implementation; base training and
assessment needs on the Department of Homeland Security's After Action report
followin all disease outbreak investi ations and exercises.
Eagle SOW FINAL.doc Page 1
Eagle County Public Health Nursing Service
2004-2005 Scope of Work
Public Health Preparedness and Response
Program Activities
Proiect Area Z: IT & Communications Infrastructure: Develop, maintain, and update IT systems,
communication systems, and databases to ensure the ability of public health communication and information
management staff throughout the state to respond to an emergency.
In order to achieve the above ob'ective and reach the desi nated milestones contractor shall•
Activities /Tasks Associated Completion
Milestones Date s
1. Ensure access to a high-speed link from the contractor's computer network to an 2.1, 2.4 09/O1/2004-
Internet Service Provider. The Internet connection should be available at all times 08/31/2005
and should not require manual dial-up each time for connection. The contractor will
serve as a contact oint for secure Internet transactions with the state.
2. Maintain an up-to-date telephone/fax/email directory of public health and other 1.6, 2.2, 2.3, 4.6, 9/1/04-8/31/05
emer enc artners Local and State
3. Maintain IT s stems with redundant method of alertin 1.6, 2.2, 2.3, 9/1/04-8/31/05
4. Review and u date, as needed, a enc communications lan 1.5, 9/1/04-8/31/05
Proiect Area 3: Training & Exercising: Train, exercise, and evaluate all-hazard public health emergency
response systems to ensure a well planned, adequately resourced, organized, and coordinated approach to
emergency response, with an emphasis on acts of bioterrorism, disease outbreaks, or events requiring use of the
Strategic National Stockpile.
In order to achieve the above obiective and reach the desiunated .r,t~P~t~nP~_ ~.,„~r~..r..r ~ti.,n.
--- -~ -
Activities /Tasks
Associated
Milestones
Completion
Date s
1. Activel artici ate in an desi ated statewide exercises. 3.7, 3.12, 3.13 TBD
2. Attend one re Tonal, state or national ublic health trainin event or conference 3.5, 3.12, 9/1/04-8/31/05
3. Partici ate in all bi-re Tonal all-hazard exercises 3.5, 3.12, 9/1/04-8/31/05
4. Partici ate in Coun all-hazard exercises 3.5, 3.12, 9/1/04-8/31105
5. Conduct annual review of staff core competencies for public health preparedness
as outlined b CDC 3.6, 3.14 9/1/04-8/31/05
6. Develo a enc trainin strate to address core co etenc a s 3.3, 3.4, 3.6, 9/1/04-8/31/05
7. In collaboration with regional staff, participate in county tabletop exercises. 3.3, 3.4, 3.6, 3.7,
3.8, 3.9, 3.10,
3.11, 3.12, 3.13,
3.14 9/1/04-8/31/05
Eagle SOW FINAL.doc Page 2
Eagle County Public Health Nursing Servlce
2004-2005 Scope of Work
Public Health Preparedness and Response
Program Activities
Project Area 4: Disease Investigation and Control: State and local public health partners will ensure
appropriate epidemiological response is provided in the event of a public health emergency.
In order to achieve the above objective and reach the designated milestones, contractor shall:
Activities /Tasks Associated Completion
Milestones Dat s
l.Work with local health care providers to ensure that the State receives information 3.1, 3.2, 4.1, 4.3, 9/1/04-8/31/05
about re ortable disease cases as re uired b Statute
2. Operate in accordance with State Statute with regard to disease investigation and 3.2, 4.1, 4.3, 9/1/04-8/31/05
control
3. Provide information to CDPHE, the State Field Epidemiologist, or to the Regional 3.1, 3.2, 4.7, 9/1/04-8/31/05
Epidemiologist (When assistance is required by the Field Epidemiologist), to
confum diagnosis, investigate causes, and identify other cases related to the
outbreak
4. Work with the Regional epidemiologist in the development of tools to enhance 4.8 9/1/04-8/31/05
the disease investigation process in the region. This may include the development of
questionnaires, data management standards, investigation protocols, GIS files, or
other information as requested by the regional epidemiologist as it relates to projects
defined in the re Tonal work lan.
5. Collaborate and support regional epidemiologist to ensure appropriate training 4.2, 4.4, 4.5 9/1/04-8/31/05
and development requirements are achieved that address identified areas of need.
In collaboration with regional staff, participate in exercises, assessments,
epidemiologic response activities; ensure 24/7 electronic reporting of diseases and
unusual disease occurrences; maintain ongoing analysis of surveillance data.
Billing Schedule: Contractor shall submit monthly invoices to CDPHE and shall be paid on a cost reimbursement
basis only. Contractor shall submit copies of receipts for all equipment purchases. Transfer of funds from one
budget line item to another is permissible. Total cost to CDPHE shall not exceed the total budget amount.
Contractor understands and agrees that none of the funding made available pursuant to this procurement agreement
can be used on any work or project other than that specified in this Scope of Work. Contractor further understands
that Contractor is not to include any work not related to the Scope of Work, attached to this procurement
agreement, on any invoices to the State. If Contractor mistakenly includes any unrelated work on an invoice,
submitted pursuant to this procurement agreement, then Contractor hereby agrees to return this amount of money to
the state immediately upon it becoming or being made aware.
Attachment A: Budget
Eagle SOW FINAL.doc Page 3
Attachment A: Project Budget
Description of Budget Item Budget Amaunt
Personnel .39 FTE (Senior level sta 23,712
(salary, Fringe, Indirect,
' Frin a estimate of 23% 5,454
E, etc.)
°lo of F1
Deliverables: 1.1, 1.2, 1.3, 1.4, 1.5, 1.6, 1.7, 1.10, 2.1-2.4, 3.1-3.7,
3.12-3.14, 4.1, 4.3, 4.7, 4.8
Personnel Seib-Total 29,166
Equipment U date co uters, cell hones, PDA's 500
(Example Computers, Deliverables: 1.6, 2.1, 2.2, 2.3, 2.4
Phones)
Equipment Sub-Total 500
Travel In and Out of State meetin s, trainin s, conferences 3,368
(Ia-Statelout-state) hotel, er diem, miles e, etc.
*Attendance at 6 regional Deliverables: 1.1, 3.5, 3.7, 3.12, 3.13
meetings/trainings
Travel Sub-Tatal 3,368
Operating/ PhonelFaxJlnternet Service, Office Su lies, Posts e, Printin 500
Supplies Deliverables: 1.1,1.3, 1.6, 2.2, 2.3, 2.4, 3.5, 3.7, 3.12, 3.13
(Not part of Indirect)
(Example: Rent, Printing,
Posta
Phone bills)
e
g
,
Operating/Supply Sub-Total 500
Indirect (20.29% of Salaries and Fringe) 5,917
(Please give % and areas
included, i.e. personnel,
di
t
d/
or
rect cos
s)
an
Indirect Sub-Total 5,917
TOTAL BUDGET AMOUNT 39,451
Agency Budget Page 1
To: Colorado Deot. of Public Health & Environment
Address: 4300 Cherry Creek Drive South, A-3
Denver, CO 80246
Attn: Brian Hancock Fax: 303-691-7811
Program: Public Health Preparedness & Response
for Bioterrorism
From:
Address:
Contact:
Date of Expenditure: From:
To:
Phone:
Contract/PO Number:
Final Invoice: Yes No FEIN:
S#C~ _C4}.~&£ ;, Ngg~Yd~3~ .S~i~...:~s'.~: } l- fin' _ F'~-'h Y. -S"L •.,'% ,C'4A3~'dr~:ycf- ei r4~~Vn.r~!,s.~'', `^l-~a
~.a;1Y. .~~"'~k.. ra"+4° ~"d`$• !65'• ~ ~~~`K~.. ~ ~-. F,,,Fp.u ti `.~~. ~4q ai~fifi3ii•+ Y {}
~:.~s~!'Ti~'i1 ~ -{ i°.~'S .' -,1 ti~± 4 m' +e Sd` •~ \~~Ya x~~'.'.E~24a~s~s~ ~ T v~` -
-tl.k° H -..
i-i`Rl' ti~ fi'
Personnel;
l.~ ~
Equipment:
Copies or Receipts Required
~:~~~ ~ :j~`~2 K R ' 6-ir .j;.{; t', `iP f~~°~4''wi~P fl
Travel:
,i- i~s - ,'k' ~ ,~ ., ..y.-P,~` [~.dp~. ~e';'.y ',~~r~+-'~iyY
ifs. '.~'>. ~.~.71sT ., dDT~4'^-. _ ~~~~~F3: `~4:_' $S ~~`7 ~_, _~
'.ri/wv~+s~}~iS ~Yb-,
Operating/
Supplies:
-.~;. x . .~...;~e~t~- eke ~~~ - ~:~~u ~~,~4~~~:~;~;~:~.
Indirect /Other
(Please give % and areas
' ~ ~
• ~~
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~ ~ .-J+!ei.y,..~,+. ~YY _~ i '; iii alky~w . _{
't," ° _ _ .'Y ..,, x.. M..!.tr i~,'- d.: ezur~:^ ..:a:` -' :,i..a - .'~.`,aih,, o, t.~w ,r j .'
:}~, ~~"f~!~~^f~~.bt }~+~(, 1 r w`- +` i/~y~ i}'':
i ~ di i." l; F.` tv'.`.` ~'J:'.;-. _~~ ~ V,9 ~~ x,e. ~^:;, - •~,
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~P-i-`~ S. ~: "9X :S^„,{,5y,,..y
: F ,,.~ a •Aa ~~°.~ ~}.4'< :~~ 7 `ice, :.amity
I certify the expenses listed above were incurred by our agency; are true and just in all respects and are in compliance with the above referenced
Contract /Purchase Order.
Signature (CONTRACTOR):
Date:
As a State designee, I hereby certify that al! contract requirements have been met, the requested amounts are correct and the payment u authorized.
Signature (CDPHE):
Date:
Monitor Initial: