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HomeMy WebLinkAboutC07-194 CDPHEDEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
ROUTING NO. 08 FFA 00004
APPROVED TASK ORDER CONTRACT — WAIVER #154
This Task Order Contract is issued pursuant to Master Contract made on 01/23/2007, with routing number 08 FAA 00016
STATE:
State of Colorado for the use & benefit of the
Department of Public Health and
Environment
Consumer Protection Division
City/County Environmental Health Program
4300 Cherry Creek Drive South
Denver, Colorado 80127
TASK ORDER MADE DATE:
April 23, 2007
PO/SC ENCUMBRANCE NUMBER:
PO FFA CPD0800004
TERM:
This Task Order shall be effective upon
approval by the State Controller, or designee,
or on 07/01/2007, whichever is later. The
Task Order shall end on 06/30/2012.
PRICE STRUCTURE:
Fixed
PROCUREMENT METHOD:
Exempt
BID/RFP/LIST PRICE AGREEMENT NUMBER
Not Applicable
LA\'V SPECIFIED VENDOR STATUTE:
Not Applicable
STATE REPRESENTATIVE:
Patricia Klocker
Department of Public Health and Environment
Consumer Protection Division
City/County Environmental Health Program
4300 Cherry Creek Drive South
Denver, CO 80127
CONTRACTOR-
Board
ONTRACTORBoard of County Commissioners of
Eagle County
500 Broadway
Eagle, CO 81631
CONTRACTOR ENTITY TYPE:
Colorado Political Subdivision
CONTRACTOR FEIN OR SOCIAL SECURITY NUMBER:
846000762
BILLING STATEMENTS RECEIVED:
Quarterly
STATUTORY AUTHORITY:
C.R.S. 25-4-1601; C.R.S. 25-1.5-101; C.R.S. 29-
1-201
CONTRACT PRICE NOT TO EXCEED:
$129,931.95
FEDERAL FUNDING DOLLARS: $0
STATE FUNDING DOLLARS: $129,931.95
MAXIMUM AMOUNT AVAILABLE PER FISCAL YEAR
FY 08:
$25,986.39
FY 09:
$25,986.39
FY 10:
$25,986.39
FY 11:
$25,986.39
FY 12:
$25,986.39
CONTRACTOR REPRESENTATIVE:
Chairperson of the Board of the County
Commissioners of Eagle County
Board of the County Commissioners of Eagle
County
500 Broadway
Eagle, CO 81631
SCOPE OF WORK:
Contractor shall provide community Consumer Protection Services, including but not limited to: the
sanitary regulation (including product sampling) of retail food establishments, schools, child care
centers, summer camps, mobile home parks, campgrounds, motels and hotels; respond to
environmental health emergencies in its service area; and complete reasonable requests by the State to
provide assistance in various program activities.
Page 1 of 4
Additional Provisions -_Exhibit A, and its attachments if included, to this Task Order Contract; 4) the
Scope/Statement of Work - Exhibit B, and its attachments if included, to this Task Order Contract; 6) other
exhibits/attachments to this Task Order Contract in their order of appearance.
4. The Contractor, in accordance with the terms and conditions of the Master Contract and this Task Order
Contract, shall perform and complete, in a timely and satisfactory manner, all work items described in the
Statement of Work and Budget, which are incorporated herein by this reference, made a part hereof and
attached hereto as "Exhibit B".
The State, with the concurrence of the Contractor, may, among other things, prospectively renew or extend
the term of this Task Order Contract, subject to the limitations set forth in the Master Contract, increase or
decrease the amount payable under this Task Order Contract, or add to, delete from, and/or modify this
Task Order Contract's Statement of Work through a "Limited Amendment for Task Orders" that is
substantially similar to the sample form Limited Amendment that is incorporated herein by this reference
and identified as Exhibit C. To be effective, this Limited Amendment must be signed by the State and the
Contractor, and be approved by the State Controller or an authorized delegate thereof. Upon proper
execution and approval, this Limited Amendment shall become a formal amendment to this Task Order
Contract. This contract is subject to such modifications as may be required by changes in Federal or State
law, or their implementing regulations. Any such required modification shall automatically be incorporated
into and be part of this Task Order Contract on the effective date of such change as if fully set forth herein.
6. The conditions, provisions, and terms of any RFP attached hereto, if applicable, establish the minimum
standards of performance that the Contractor must meet under this Task Order Contract. If the Contractor's
Proposal, if attached hereto, or any attachments or exhibits thereto, or the Scope/Statement of Work -
Exhibit B, establishes or creates standards of performance greater than those set forth in the RFP, then the
Contractor shall also meet those standards of performance under this Task Order Contract.
Page 3 of 4
EXHIBIT A
ADDITIONAL PROVISIONS
To Task Order Contract Dated 01/23/2007 - Contract Routing Number 08 FFA 00004
These provisions are to be read and interpreted in conjunction with the provisions of the
Task Order Contract specified above.
Health Insurance Portability and Accountability Act (HIPAA) Business Associate Determination.
The State has determined that this contract does not constitute a Business Associate relationship under
HIPAA.
To receive compensation under this Task Order Contract, the Contractor shall submit a quarterly
Invoice/Cost Reimbursement Statement in a format acceptable to the State. A sample Invoice/Cost
Reimbursement Statement is attached hereto as Attachment A and incorporated herein by this reference.
An Invoice/Cost Reimbursement Statement must be submitted within fifteen (15) calendar days of the end
of the billing period for which services were rendered. Expenditures shall be in accordance with the
Statement of Work attached hereto as Exhibit B and incorporated herein. These items may include, but are
not limited to, the Contractor's salaries, fringe benefits, supplies, travel, operating, indirect costs which are
allowable, and other allocable expenses related to its performance under this Task Order Contract.
Invoice/Cost Reimbursement Statements shall: 1) reference this Task Order Contract by its contract routing
number, which number is located on page one of this Task Order Contract; 2) state the applicable
performance dates; 3) state the names of payees; 4) include a brief description of the services performed
during the relevant performance dates; 5) describe the incurred expenditures if reimbursement is allowed
and requested; and, 6) show the total requested payment. Payment during the initial, and any renewal or
extension, term of this Task Order Contract shall be conditioned upon affirmation by the State that all
services were rendered by the Contractor in accordance with the terms of this Task Order Contract.
Invoice/Cost Reimbursement' Statements shall be sent to:
Elizabeth Williams
Consumer Protection Division
Fiscal Officer
Colorado Department of Public Health and Environment
CPD -B2
4300 Cherry Creek Drive South
Denver, CO 80246
To be considered for payment, billings for payments pursuant to this Task Order Contract must be received
within a reasonable time after the period for which payment is requested, but in no event no later than sixty
(60) calendar days after the relevant performance period has passed. Final billings under this Task Order
Contract must be received by the State within a reasonable time after the expiration or termination of this
Task Order Contract; but in no event no later than sixty (60) calendar days from the effective expiration or
termination date of this Task Order Contract.
Page 1 of 1
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EXHIBIT B
STATEMENT OF WORK AND BUDGET
To Task Order Contract Dated 01/23/2007- Contract Routing Number 08 FFA 00004
These provisions are to be read and interpreted in conjunction with the provisions of the Task Order Contract specified above.
STATEMENT OF WORK
The Contractor shall provide community Consumer Protection Services, which services shall include, but
are not limited to: the sanitary regulation (including product sampling) of retail food establishments,
schools, child care centers, summer camps, mobile home parks, campgrounds, motels and hotels;
responding to environmental health emergencies, as defined by the State, in its service area; and the
completion of reasonable requests by the State to provide assistance in various program activities. The
Contractor shall provide these services in compliance with the State "Food Protection Act" as set forth in
"Delegation of the Food Protection Act and Information Reporting", incorporated herein by this reference,
made a part hereof, and attached hereto as Attachment B-1.
From July 1 through June 30 of each year of this Contract, the Contractor shall complete the following
activities in its service area:
a. Two (2) inspections, when required, for all retail food establishments;
b. One (1) inspection of all schools that contain a laboratory or shop;
c. One (1) inspection of each child care center;
d. One (1) inspection of each summer camp;
e. An inspection, in a timely manner, of any mobile home park, campground, motel or hotel after the
Contractor receives a complaint of any such facility;
f. Review of all submitted plans in a timely manner;
g. Collect one (1) sample of each: hamburger or ground beef and sausage produced by each retail
market at least once every five (5) years and submit that sample to the Colorado Department of
Public Health and Environment, Laboratory Services Division; and
h. One (1) inspection of all schools that do not contain a laboratory or shop at least once every three
(3) years.
On or after the effective date of this Contract all persons employed by the Contractor to complete its duties
and obligations under this Contract, shall meet the minimum qualifications established by the State's
Department of Public Health and Environment, Consumer Protection Division. These minimum standards
are contained in the State's "Procedure for Administering the City/County Environmental Health Program,"
which is incorporated herein by this reference, made a part hereof, and attached hereto as Attachment B-2.
If the Contractor cannot determine if an employee or applicant meets the minimum qualifications for
education or experience, then the Contractor shall submit an employee's credentials or an applicant's
application to the State for review and approval prior to employment under this contract.
4. The Contractor shall submit all inspection reports, a sample of which is incorporated herein by this
reference, made a part hereof, and attached hereto as Attachment B-3, within five (5) working days after
the last day of each month for all services covered by this contract. Inspection report forms will be
furnished to the Contractor by the State on an as needed basis.
5. Should the Contractor be unable to fulfill its duties under this Task Order, then the Contractor shall
transmit to the Colorado Department of Revenue one -twelfth of the total amount of annual license fees
collected, per each month that the duties delegated pursuant to 25-4-1604 (1)(i) are not performed.
Page 1 of 2
ATTACHMENT B-1
DELEGATION OF THE "FOOD PROTECTION ACT" AND INFORMATION REPORTING
To Task Order Contract Dated 01/23/2007- Contract Routing Number 08 FFA 00004
These provisions are to be read and interpreted in conjunction with the provisions of the Task Order Contract specified above.
This document is to clarify the roles of the Colorado Department of Public Health and Environment, Consumer
Protection Division, and the Contractor, as regards the delegation of responsibilities under the "Food Protection
Act", C.R.S. 25-4-1604 (a), (c), (d), (e), and (h) to the Contractor, from the Colorado Department of Public Health
and Environment (CDPHE), Consumer Protection Division (CPD) and the reporting of information by the
Contractor to the CDPHE, CPD.
As regards the delegation of the "Food Protection Act", the Contractor is to:
1. Grant or refuse licenses and certificates of license pursuant to C.R.S. 25-4-1606, or to suspend or revoke
licenses and certificates of license pursuant to C.R.S. 25-4-1609.
2. Hear and determine all complaints against licensees or grantees of certificates of license and administer
oaths and issue subpoenas to require the presence of any person necessary to the determination of any such
hearing.
3. Use and require compliance with the "Food Protection Act," C.R.S. 25-4-16 et Seq. , the "Colorado Retail
Food Establishment Rules and Regulations," 6 CCR 1010-2, and all other documents issued by CDPHE
which are used to clarify interpretation of the law, rules and regulations.
4. Enter retail food establishments during business hours and at other times during which activity is evident to
conduct inspections and other interventions related to food safety and protection of public health.
5. Review and approve Hazard analysis Critical Control Point (HACCP) plans submitted for evaluation to
verify and ensure that food handling risks are reduced to prevent foodborne illness outbreaks.
In regards to the reporting of information and other activities, the Contractor is to:
1. Report in aggregate, in a mutually agreeable format, to CPD, for a calendar year:
a. The number of inspections conducted;
b. If critical items identified on retail food establishment inspections were corrected;
c. Whether the required inspection frequency was met; and
d. The number of enforcement actions taken to obtain compliance in retail food establishments.
The required inspection frequency is dependent upon which method is used as outlined in Section 11-201
of the "Colorado Retail Food Establishment Rules and Regulations."
2. Have performance measures to assure that employees cite critical item violations on retail food inspections
and take the appropriate measures to ensure that these violations are corrected. Such performance
measures are to be developed and used by the Contractor.
3. Report to CPD the number of foodborne illness complaints received and the number of foodborne illness
outbreaks that occur. The format and frequency of the reports shall be a format and frequency mutually
agreeable to the CPD and the Contractor.
4. Have one employee, who meets the eligibility requirements, apply for retail food establishment
Standardization through the CPD.
5. Report annually, in aggregate, the frequency of inspections conducted for child care centers and indicate
whether the required inspection frequencies for each program have been met. The format of the reports
shall be a format mutually agreeable to the CPD and the Contractor.
In regards to the delegation of the "Food Protection Act" and the reporting of information, CPD will:
1. Provide statewide interpretation and technical assistance relative to the "Colorado Retail Food
Establishment Rules and Regulations" and food safety and sanitation.
2. Provide standardization to Contractor personnel.
Pagel of 2
ATTACHMENT B-1
3. Provide training seminars for retail food inspectors.
4. Provide equipment review, product review, and other services necessary to assure the uniform
interpretation and application of the rules promulgated under C.R.S. 25-4-16 et sea.
5. Provide the format and frequency needed to report the number of inspections conducted, if critical items
identified on retail food establishment inspections were corrected, whether the required inspection
frequencies were met, and the number of enforcement actions taken to obtain compliance in retail food
establishments. The format and frequency shall be a format and frequency mutually agreeable to the CPD
and the Contractor.
6. Provide the format and frequency needed to report the number of foodborne illness complaints received and
the number for foodborne illness outbreaks that occur. The format and frequency shall be a format and
frequency mutually agreeable to the CPD and the Contractor.
7. Provide the format and the frequency for reporting the number of inspections conducted for child care
centers and determine whether the required inspection frequencies for the program have been met. The
format and frequency shall be a format and frequency mutually agreeable to the CPD and the Contractor.
8. Disseminate information relative to food safety to local agencies, industry organizations, academia, and
others when necessary.
9. Share statewide the data collected by CPD and the Contractor relative to this document.
10. Periodically review the Contractor for compliance with responsibilities as stated herein.
Page 2 of 2
ATTACHMENT B-2
PROCEDURES FOR ADMINISTERING THE CITY/COUNTY ENVIRONMENTAL HEALTH
PROGRAM
To Task Order Contract Dated 01/23/2007- Contract Routing Number 08 FFA 00004
These provisions are to be read and interpreted in conjunction with the provisions of the Task Order Contract specified above.
Additional Programs
a. Before any local entity is approached about entering into the City/County Environmental Health
Program, the Colorado Department of Public Health and Environment, Consumer Protection Division
(CPD) will establish a list of target counties. These target counties will be selected by considering
workload, geographic proximity to direct -service work areas and available environmental health
officer funds.
b. Presentations to local entities describing the City/County Environmental Health Program will include
the benefits to the local entities, as well as the requirements of the contract, including the workload,
personnel qualifications, functions to be conducted, reporting and contract enforcement procedures.
2. Budget Procedures
CPD will be responsible for administering the budget. This administration will include the drafting and
approval of contracts, approval for payment and any necessary cancellations or modifications. CPD will be
responsible for notifying local entities of any actions contemplated, or correspondence concerning performance.
3. Standards for Staffing Counties
Funding will be based on the number of required annual inspections using the Work Formula Table below. The
percentage that each county's required number of inspections represents of the total amount required for all
counties participating in the program will be determined. This will be the percentage of available legislative
appropriated funds that a county will receive for the successful completion of their required inspections.
Reimbursement will be paid on a quarterly basis.
WORK FORMULA TABLE
Program
Required Number of Inspections Per Year
Retail Food Inspection
2
Retail Food Inspections
1
Retail Food Establishment Plan Reviews
As submitted
Child Care Centers
1
Meat Samples
Once/5 years
Schools with Labs and/or Shops
1
Schools without Labs or Shops
Once/3 years
Summer Camps
1
Motels and Hotels
Upon complaint only
Mobile Home Parks
Upon complaint only
4. Environmental Health Officer Qualifications
a. Any governmental agency entering into a contract with the Colorado Department of Public Health and
Environment (CDPHE) must employ an individual as the lead environmental health officer who
possesses at least a BS degree in environmental health, or in a closely associated field, and at least two
years of field experience in general environmental health programs. An MPH may be substituted for
one year of field experience.
b. CDPHE will enter into contracts with entities that employ environmental health officers or technicians
without two years field experience or that do not possess a Bachelors of Science degree, if the
individual works under the direction and supervision of an environmental health officer with the
qualifications listed in 4.a. above.
Page 1 of 3
ATTACHMENT B-2
g. Any program that has not accomplished at least 60% of the required work during the first three (3)
quarters of the contract period may be offered a contract for the following year. However, the
Contractor will be notified, in writing, that CDPHE will cancel the contract after the first quarter of the
new contract period if at least 20% of the required contract work is not completed. If 20% of the
contract work is not accomplished during the first quarter, CPD will notify the Contractor in writing
that the contract will be canceled thirty (30) days following the date of the notification. If 20% of the
contract is accomplished during the first quarter, CPD will notify the Contractor in wiring that the
contract will continue on the basis of the performance criteria established the previous year. Regulated
establishments that have discontinued operations during the year will not be deemed to have been
included in the contract workload. New establishments will be considered on the basis of the date
operations began.
h. If a program that has been subject to the terms of these operational criteria the previous year fails to
accomplish at least 60% of the required contract work within the first three quarters of a second
consecutive contract period, the Contractor will be notified in writing, by CPD, that a contract will not
be offered for the next contract period.
i. Obvious failure to carry out the provisions or mandates of established laws or regulations and
interpretations thereof governing establishments regulated under the contract will also be deemed
sufficient reason for not renewing a contract.
j. The quality of work performed will be determined by CPD, utilizing service data, inspection records,
and field evaluation.
k. Should CPD find that a Contractor is not performing the Contract functions properly, the Contractor
will be notified accordingly, and appropriate field training will be scheduled. A Contractor will be
deemed to be not performing adequately if the Contractor is not documenting violations appropriately
on the inspection report form.
1. Three (3) months following field training, the performance of the Contractor's inspectional personnel
will be evaluated again. If improvement has not been made, the Contractor will be notified in writing
that performance requires improvement.
in. Six (6) months following field training, the performance of the Contractor's inspectional personnel will
be evaluated again. If improvement has not been made, CPD will notify the Contractor in writing that
the Contract will be canceled thirty (30) days following notification.
Billing Procedures
a. At the end of each contract quarter, the Contractor will complete the Cost Reimbursement Statement
(CRS) form, attached to this Contract at Attachment A, and submit it to CPD.
b. CPD will review the CRS for completeness and accuracy of reimbursement cost. CPD will review
office records to determine if required inspection reports have been received.
c. All inspection reports must be submitted monthly. The Contractor shall submit all inspection reports
within five (5) working days after the last day of each month for all services covered by this contract.
If the required inspection reports have not been received, the Contractor will be notified that reports
have not been received and that payment cannot be made until they have been received.
d. If the CRS is complete and reports have been received, CPD will remit payment to the Contractor.
e. Failure to submit required inspection reports for a period of three (3) consecutive months will result in
contract cancellation.
Page 3 of 3
tu
Cobradn Departmem
of Public Health
and Environment
ATTACHMENT B-3
COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
4300 CHERRY CREEK DRIVE SOUTH
DENVER, CO 80246-1530
PHONE (303) 692-3620 FAX (303) 753-6809 Page one of
License #
ESTABLISHMENT
OWNER NAME
ADDRESS
ZIP CODE
COUNTY
FIRM ID
INSPECTOR ID
DATE
TRAVEL TIME
INSPECT TIME
TYPE
b. Wholesome, free of spoilage
d. HACCP plan
b.
Food protected from contamination
MENEMEM
❑ Compliance Agreement
10
EQUIPMENT DESIGN, CONSTRUCTION
Regular
e. Smoking, eating, drinking
a.
Food -contact surfaces c. Dishwashing facilities
MONTH
DAY
YEAR
Nonfood -contact surfaces
b. Wounds properly covered
Follow-up
c. Hands washed as needed
from bare hands
11
TESTING DEVICES
d. Hygienic practices
a.
Refrigeration units provided with accurate, conspicuous thermometer
b.
Dishmachine provided with accurate thermometer & gauge cock
Temperature Control Procedures
c.
Chemical test kits provided, accessible
a. Rapidly cool foods to 41°F or less
Pre -Operational
b. Rapidly reheat to 165° F or greater
e. Cold hold at 41 °For less
12
CLEANING OF EQUIPMENT AND UTENSILS
c. Hot hold at 135° F or greater
Temperature Control Equipment
a.
Food -contact surfaces c. Dishwashing operations
f. Food thermometer (probe -type)
b.
Nonfood -contact surfaces d. Wiping cloths
g. Adequate equipment to maintain food temperatures
13
UTENSILS, SINGLE -SERVICE ARTICLES
Complaint
KE I AIL FOOD ESTABLISHMENT INSPECTION REPORT
Items circled below identify violations to be corrected as indicated by the reeulatory authority
Red — Critical Items: These items related directly to foodborne illness.
b. Linen properly stored
Recommended Regulatory Action(s)
Resolution(s) & Interventions
09
FOOD LABELING, FOOD PROTECTION
a. Approved Source
c. Cross -contamination
a.
Original container, properly labeled
b. Wholesome, free of spoilage
d. HACCP plan
b.
Food protected from contamination
MENEMEM
❑ Compliance Agreement
10
EQUIPMENT DESIGN, CONSTRUCTION
Employee Health/ Hygienic Practices
e. Smoking, eating, drinking
a.
Food -contact surfaces c. Dishwashing facilities
a. Personnel w/infections restricted
f. Demonstration of knowledge
b.
Nonfood -contact surfaces
b. Wounds properly covered
g. Preventing food contamination
c. Hands washed as needed
from bare hands
11
TESTING DEVICES
d. Hygienic practices
a.
Refrigeration units provided with accurate, conspicuous thermometer
b.
Dishmachine provided with accurate thermometer & gauge cock
Temperature Control Procedures
c.
Chemical test kits provided, accessible
a. Rapidly cool foods to 41°F or less
d. Required cooking temperature
b. Rapidly reheat to 165° F or greater
e. Cold hold at 41 °For less
12
CLEANING OF EQUIPMENT AND UTENSILS
c. Hot hold at 135° F or greater
Temperature Control Equipment
a.
Food -contact surfaces c. Dishwashing operations
f. Food thermometer (probe -type)
b.
Nonfood -contact surfaces d. Wiping cloths
g. Adequate equipment to maintain food temperatures
13
UTENSILS, SINGLE -SERVICE ARTICLES
a.
Utensils provided, used, stored
Temperature
Concentration Exposure
b.
Single -service articles stored, dispensed, used
a. Manual
c.
No reuse of single -service articles
b. Mechanical
14
PHYSICAL FACILITIES
c. In -Place
Sanitizer: Chlorine Quaternary Ammonium Other
a.
Plumbing: installed, maintained f. Locker rooms
b.
Garbage and refuse g. Premises maintained
c.
Floors, walls, ceilings h. Separation of living, laundry
a. Safe water source
c. Backflow, backsiphonage
d.
Lighting i. Restroom facilities
b. Hot & cold water under pressure
d. Sewage disposal
e.
Ventilation
a. Adequate number, location
b. Accessible
c. Soap & drying devices available
a. Evidence of insects or rodents
b. Pesticide application
c. Animals prohibited
a. Properly stored
b. Properly labeled
c. Properly used
ENVIRONMENTAL HEALTH SPECIALIST:
115 OTHER OPERATIONS
a. Personnel: clean clothes, hair restraints, authorized
b. Linen properly stored
Recommended Regulatory Action(s)
Resolution(s) & Interventions
❑ ]St Notification of Non -Compliance
❑ V Compliance Warning Letter
❑ Additional Notification of Non-
❑ Additional Compliance
Compliance
Warning Letter
❑ Notice of Civil Penalty
❑ Voluntary Closure Release
❑ Final Order of Civil Penalty
❑ Embargo Release
❑ Revocation/License Suspension
❑ Compliance Agreement
On-site Regulatory Actions
❑ On -Site Training
❑ Voluntary Closure
❑ HACCP Study
❑ Embargo Notice
❑ Announced Inspection
❑ Voluntary Condemnation
❑ FDA Documented Inspection
RECEIVED BY:
Form RF001-1_revH_InspectionReport_0506 CIVCS: Yes No On-site Follow -Up: Yes No
EXHIBIT C
DEPARTMENT OR AGENCY NAME
COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
(ADD PROGRAM NAME HERE)
DEPARTMENT OR AGENCY NUMBER
***
CONTRACT ROUTING NUMBER
LIMITED AMENDMENT #*
This Limited Amendment is made this * * * * day of *********, 200*, by and between the State of Colorado, acting
by and through the DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT, whose address or principal
place of business is 4300 Cherry Creek Drive South Denver Colorado 80246, hereinafter referred to as the
"State"; and, LEGAL NAME OF ENTITY (legal tune of entity), whose address or principal place of business is
Street Address, City, State & Zia Code, hereinafter referred to as the "Contractor".
FACTUAL RECITALS
The parties entered into a contract dated ******** ** **** with contract encumbrance number PO ***
*
folllowinlowin , and contract routing number ** *** ***** whereby the Contractor was to provide to the State the
g::
(briefly describe what the Contractor was to do under the original contract — indent this paragraph j
[Please choose one of the following four options and then delete this heading and the other three options not
selected:]
The State promises to [choose one and delete the otherlincrease/decrease the amount of funds to be paid to the
Contractor by ********** Dollars, ($*.**) during the current term of the Original Contract in exchange for the
promise of the Contractor to perform the [choose one and delete the otherlincreased/decreased work under the
Original Contract.
The State promises to pay the Contractor the sum of ********** Dollars,$( *.**) in exchange for the promise of
the Contractor to continue to perform the work identified in the Original Contract for the renewal term of ****
years/months, ending on ******** **, ****.
The State promises to [choose one and delete the other]increase/decrease the amount of funds to be paid to the
Contractor by ********** Dollars, $*.** for the renewal term of **** [choose one and delete the
otherlyears/months, ending on ******** **, ****, in exchange for the promise of the Contractor to perform the
[choose one and delete the otherlincreased/decreased specifications to the Scope of Work described herein.
The State hereby exercises a "no cost' change to the linsert those that apply and delete those that don'tlbudget,
specifications within the Scope of Work, project management/manager identification, notice address or
notification personnel, or performance period within the ]choose one and delete the otherlcurrent term of the
Original Contract or renewal term of the Original Contract.
NOW THEREFORE, in consideration of their mutual promises to each other, stated below, the parties hereto agree
as follows:
Consideration for this Limited Amendment to the Original Contract consists of the payments and services
that shall be made pursuant to this Limited Amendment, and promises and agreements herein set forth.
2. It is expressly agreed to by the parties that this Limited Amendment is supplemental to the original
Page 1 of 4
EXHIBIT C
conflict, inconsistency, variance, or contradiction between the terms and provisions of this Amendment and
any of the terms and provisions of the Original Contract, the terms and provisions of this Amendment shall
in all respects supersede, govern, and control. The Special Provisions shall always control over other
provisions of the Original Contract or any subsequent amendments thereto. The representations in the
Special Provisions to the Original Contract concerning the absence of personal interest of state of Colorado
employees is presently reaffirmed.
6. FINANCIAL OBLIGATIONS OF THE STATE PAYABLE AFTER THE CURRENT FISCAL YEAR
ARE CONTINGENT UPON FUNDS FOR THAT PURPOSE BEING APPROPRIATED, BUDGETED,
AND OTHERWISE MADE AVAILABLE.
Page 3 of 4
STATE OF COLORADO
Bill Ritter, Jr., Governor
James B. Martin, Executive Director
Dedicated to protecting and improving the health and environment of the people of Colorado
4300 Cherry Creek Dr. S.
Denver, Colorado 80246-1530
Phone(303)692-2000
TDD Line (303) 691-7700
Located in Glendale, Colorado
http://www.cdphe.state.co.us
July 5, 2007
Laboratory Services Division
8100 Lowry Blvd.
Denver, Colorado 80230-6928
(303)692-3090
Board of County Commissioners of
Eagle County
Attn: Chairperson of the Board
500 Broadway
Eagle, CO 81631
Re: Environmental Health Contract between the County and the State
pF cO�p
- p
1876
Colorado Department
of Public Health
and Environment
Enclosed please find the fully executed Task Order for consumer protection services to be rendered by
your county for the Colorado Department of Public Health and Environment.
Should you have any questions regarding this document, please do not hesitate to contact Patti Klocker
at 303-692-3637.
Thank you.
Sincerely,
Robin Feller
CUA-1'1�