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HomeMy WebLinkAboutC08-159DEP ~RTMENT OF PUBLIC I IEAL,'I'H .1ND ENVIRONbILNT
ROUTING NO. 09 FAA 00028
APPROVED TASK ORDER CONTRACT -WAIVER #154
This Task Order Contract is issued pursuant to Master Contract made on 01/23/2007, with routing number OS FAA 00016
STATE.
State of Colorado for the use & benefit of the
Department of Public Health and
Environment
Office of Local Liaison
Public Health Nursing Services Program
4300 Cherry Creek Drive South
Denver, Colorado 80246-1530
TASK ORDEK MADE DATE
04/01/08
PO/SC ENCUMBRANCF. NUbLBER
PO FAA OLL09000028
TERM
This Task Order shall be effective upon
approval by the State Controller, or designee,
or on 07/01 /2008, whichever is later. The
Task Order shall end on 06/30/2009.
PRICE STRUCTURE
Quarterly
PKOCURE~fENT METHOD
Exempt
BID/RFP/LIST PRICE AGREEMENT NUMBER
Not Applicable
LAIC' SPECIFIED VENDOR STATUTE
Not Applicable
STATE, REPRESENTATIVE
Karen O'Brien
Department of Public Health and Environment
Office of Local Liaison
Public Health Nursing Servtces Program
4300 Cherry Creek Drive South
Denver, CO 80246-1530
CONTRACTOR
Board of County Commissioners of Eagle
County
500 Broadway
Eagle, Colorado 81631
For the use and benefit of the
Eagle County Health and Human Services
551 Broadway
Eagle, Colorado 81631
CONTRACTOR ENTITY TYPE,
Colorado Political Subdivision
CONTRACTOR FEIN OR SOCIAL SECURITY NUMBER:
846000762
BILLING STATEMENTS RECEIVED
Not Applicable
STATUTORY AUTHORITY:
Not Applicable
CONTRACT PRICE NOT TO EMCEED
$102,181.00
STATE FUNDING DOLLARS $102,181.00
MAXIMUM AMOUNT AVAILABLE PER FISCAL. YEAR
FY 09: $102,181.00
CONTRACTOR REPRESENTATIVE
Jill Hunsaker
Eagle County Health and Human Servtces
PO Box 660
Eagle, CO 81631
SCOPE OF \K ORK
Utilize the current practice of the Public Health Nursing; use the core public health functions model
(assessment, assurance, and policy development) as a framework for organizing, delivering, and
evaluating interventions aimed at improving health.
Page 1 of 4
ExliiBrrs
The following exhibits are hereby incorporated:
Exhibit A - Additional Provisions (and its attachments if any - e.g., A-1, A-2, etc.)
Exhibit B - Statement of Work and Budget (and its attachments if any - e.g., B-1, B-2, etc.)
Exhibit C - Limited Amendment Template for Task Orders
Exhibit D - Option Letter
GENERAL PROVISIONS
The following clauses apply to this Task Order Contract. These general clauses may have been expanded upon or made
more specific in some instances in exhibits to this Task Order Contract. To the extent that other provisions of this Task
Order Contract provide more specificity than these general clauses, the more specific provision shall control.
This Task Order Contract is being entered into pursuant to the terms and conditions of the Master Contract
including, but not limited to, Exhibit One thereto. The total term of this Task Order Contract, including
any renewals or extensions, may not exceed five (5) years. The parties intend and agree that all work shall
be performed according to the standards, terms and conditions set forth in the Master Contract.
2. In accordance with section 24-30-202(1), C.R.S., as amended, this Task Order Contract is not valid until it
has been approved by the State Controller, or an authorized delegee thereof. The Contractor is not
authorized to, and shall not; commence performance under this Task Order Contract until this Task Order
Contract has been approved by the State Controller or delegee. The State shall have no financial obligation
to the Contractor whatsoever for any work or services or, any costs or expenses, incurred by the Contractor
prior to the effective date of this Task Order Contract. If the State Controller approves this Task Order
Contract on or before its proposed effective date, then the Contractor shall commence performance under
this Task Order Contract on the proposed effective date. If the State Controller approves this Task Order
Contract after its proposed effective date, then the Contractor shall only commence performance under this
Task Order Contract on that later date. The initial term of this Task Order Contract shall continue through
and including the date specified on page one of this Task Order Contract, unless sooner terminated by the
parties pursuant to the terms and conditions of this Task Order Contract and/or the Master Contract.
Contractor's commencement of performance under this Task Order Contract shall be deemed acceptance of
the terms and conditions of this Task Order Contract.
3. The Master Contract and its exhibits and/or attachments are incorporated herein by this reference and made
a part hereof as if fully set forth herein. Unless otherwise stated, all exhibits and/or attachments to this Task
Order Contract are incorporated herein and made a part of this Task Order Contract. Unless otherwise stated,
the terms of this Task Order Contract shall control over any conflicting terms in any of its exhibits. In the event
of conflicts or inconsistencies between the Master Contract and this Task Order Contract (including its exhibits
and/or attachments), or between this Task Order Contract and its exhibits and/or attachments, such conflicts or
inconsistencies shall be resolved by reference to the documents in the following order of priority: 1) the
Special Provisions of the Master Contract; 2) the Master Contract (other than the Special Provisions) and its
exhibits and attachments in the order specified in the Master Contract; 3) this Task Order Contract; 5) the
Additional Provisions -_Exhibit A, and its attachments if included, to this Task Order Contract; 4) the
Page 2 of 4
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 ItFP, then the
Contractor shall also meet those standards of performance under this Task Order Contract.
Page 3 of 4
IN WITNESS WHEREOF, the State has executed this Task Order Contract as of the day first above
written.
* Persons signing for Contractor hereby swear and affirm that they are authorized to act on
Contractor's behalf and acknowledge that the State is relying on their representations to that effect and
accept personal responsibility for any and all damages the State may incur for any errors in such
representation.
CONTRACTOR:
BOARD OF COUNTY COMNIISSIONERS OF
EAGLE COUNTY
For the use and benefit of the
EAGLE COUNTY HEALTH & HUMAN
SERVICES
Legal Name of Contracting Entity
STATE OF COLORADO:
BILL BITTER, JR. GOVERNOR
sy
For Executive Director
846000762
Social Security Number-or FEIN.; ~
i
Department of Public Health and Environment
Department Program Approval:
Signature of Authorized Officer
t~e:~er ~. I~San~A~j C'~airmaY--
Print Name & Title of A' uthorized Officer
sy
ALL CONTRACTS MUST BE APPROVED BY THE STATE CONTROLLER
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:
David J. McDermott, CPA
By
Date
Page4of4
EXHIBIT A
ADDITIONAL PROVISIONS
To Task Order Contract Dated 04/01/2008 -Contract Routing Number 09 FAA 00028
These provisions are to be read and interpreted in conjunction with the provisions of the
Task Order Contract specified above.
1. The State has determined that this contract does not constitute a Business Associate relationship under
HIPAA.
2. This Task Order Contract contains state funds.
3. Compensation under this Task Order Contract. The contractor will receive automatic quarterly payments
within thirty (30) calendar days after the quarter ends. 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.
4. Time Limit For Acceptance Of Deliverables.
a. Evaluation Period. The State shall have thirty (30) calendar days from the date a deliverable is
delivered to the State by the Contractor to evaluate that deliverable, except for those deliverables
that have a different time negotiated by the State and the Contractor.
b. Notice of Defect. If the State believes in good faith that a deliverable fails to meet the design
specifications for that particular deliverable, or is otherwise deficient, then the State shall notify
the Contractor of the failure or deficiencies, in writing, within thirty (30) calendar days of: 1) the
date the deliverable is delivered to the State by the Contractor if the State is aware of the failure or
deficiency at the time of delivery; or 2) the date the State becomes aware of the failure or
deficiency. The above time frame shall apply to all deliverables except for those deliverables that
have a different time negotiated by the State and the Contractor in writing pursuant to the State's
fiscal rules.
c. Time to Correct Defect. Upon receipt of timely written notice of an objection to a completed
deliverable, the Contractor shall have a reasonable period of time, not to exceed thirty (30)
calendar days, to correct the noted deficiencies. If the Contractor fails to correct such deficiencies
within thirty (30) calendar days, the Contractor shall be in default of its obligations under this
Task Order Contract and the State, at its option, may elect to terminate this Task Order Contract or
the Master Contract and all Task Order Contracts entered into pursuant to the Master Contract.
The State may unilaterally increase/decrease the maximum amount payable under this contract based upon
the unit prices established in the contract and the schedule of services required, as set by the State. If the
State exercises its option, it shall provide written notice to the contractor at least 30 days before the increase
is effective in a form substantially equivalent to Exhibit D, immediately upon signature of the State
Controller or his delegate. Performance of the service shall continue at the same rates and under the same
terms as established in the contract.
6. Survival of Certain Contract Terms. Notwithstanding anything in this contract to the contrary, the parties
understand and agree that all terms and conditions of this contract which may require continued
performance, compliance, or effect beyond the termination date of the contract and shall survive such
termination date and shall be enforceable by the State as provided herein in the event of failure to perform
or comply by the Contractor.
To be attached to CDPHE Page 1 of 1 Revised: 12/19/06
Task Order v 1.0 (11/OS) contract template
EXHIBIT B
STATEMENT OF WORK
To Task Order Contract Dated 04/01/2008 -Contract Routing Number 09 FAA 00028
These provisions are to be read and interpreted in conjunction with the provisions of the Task Order Contract specified above.
1. The Contractor, in accordance with the terms and conditions of this contract, shall perform and complete, in
a timely and satisfactory manner, all activities described in the approved Scope of Work that is attached
hereto as Attachment B-1 and incorporated herein.
2. The Contractor shall perform a community health assessment at least once every five (5) years and submit a
three year planning report to the State's Office of Local Liaison ("OLL") based upon data obtained in the
five-year community health assessment as stated in the Scope of Work that is attached hereto as
Attachment B-1.
3. The Contractor shall submit its community health plan progress report on or before January 318` for each
year that this contract is in effect.
To be attached to CDPHE Page 1 of 1 Revised: 12/19/06
Task Order v1.0 (11/OS) contract template
Attachment B-1
Public Health Nursing Scope of Work
DUTIES AND OBLIGATIONS OF THE CONTRACTOR.
The current practice of Public Health uses the core public health functions model
(assessment, assurance, and policy development) as a framework for organizing,
delivering, and evaluating interventions aimed at improving health. The ten essential
public health services, outlined in the "The Operational Definition of a Functional Local
Health Department" by the National Association of City and County Health Officials
delineate and describe the core public health functions. This model can be referenced to
guide strategic decisions for provision of public health services within a jurisdiction.
Colorado allocates state general fund dollars thru the Long Bill to provide public health
nursing in Part 6 (C.R.S. 25-1-608) rural counties in accordance with 25-1-516 C.R.S. In
addition, Colorado local public health services and County Boards of Health shall receive
Tobacco Litigation Settlement moneys to provide support for basic and optional public
health services, as defined by the State Board of Health in accordance with Section 24-
75-1104.5 (1.5) (a) (IV). A copy of the current definition of Basic and Optional Public
Health Services and Core Public Health model shall be posted on the Office of Local
Liaison website.
Five Year Community Health Assessment
The Contractor shall perform a community health assessment at least once every five
(5) years and submit a three year planning report to the State's Office of Local
Liaison ("OLL") based upon data obtained in the five-year community health
assessment. The Contractor assures development, implementation, and evaluation of
a community health assessment. The written report submitted on a state provided
electronic template shall include, but is not limited to, the following information:
A. An analysis of the available community health data (including Maternal
and Child Health performance measures) to identify the priority
community health related needs. The Mobilizing for Action through
Planning and Partnerships (MAPP) is a community wide strategic
planning tool for improving community health endorsed by the National
Association of County and City Health Officials and supported by the
OLL with a link posted on the OLL website.
B. A report and discussion of the top three primary local public health issues
identified in the community assessment process. The discussion should
include, but does not need to be limited to a review of the Contractor's
prenatal, child, adolescent, and special needs populations; and an
integration of comprehensive coordinated medical home approach into
the MCH activities of the three year plan.
Public Health Nursing Scope of Work
2. Annual Community Health Plan
The Contractor shall submit progress toward a three year "Community Health Plan"
to the State's Office of Local Liaison for each calendar year that this Contract is in
effect. A reporting template will be posted on the OLL website.
The Contractor shall submit its community health plan progress report on or before
January 31 for each year that this Contract is in effect. The Annual Community
Health Plan Progress report shall include, but is not limited to, the following
information:
A. An outline of the Contractor's goals and objectives for three calendar years
(2008-2010) covered by the Plan to address the primary local public health
issues identified in the 5 year community assessment;
B. The public health interventions the Contractor intends to provide in the
calendar year covered by the Plan to meet the annual goals and objectives;
C. On or before une of each year that this Contract is in effect, the Contractor
shall review the "Annual Community Health Plan Summary Report" with its
assigned State consultant to identify any short or long term support needs
from the State.
D. On or before January 31St, an evaluation of the progress made on the
Community Health Plan will be submitted. The OLL will provide technical
assistance and,
E. A copy of the local public health agency annual budget to demonstrate the
local contribution to public health according to Section 25-1-516 C.R.S. A
reporting template will be posted on the OLL website.
The American Nurses Association Scope and Standards of Public Health Nursing (2007) states
"The baccalaureate degree in nursing is the educational credential for entry into public health
nursing practice." This publication serves as a national standard and guide for public health
nursing practices. The Colorado Department of Public Health and Environment strongly
encourages the Contractor to abide by, and achieve, the standards contained in this publication.
A copy of all employed active Registered Nurse licenses will be kept on file by the contractor
with timely communication to the OLL on the employment status of all RNs in the agency.
July O1, 2008-June30, 2009
EXHIBIT C
DEPARTMENT OR AGENCY NAME
COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
(ADD PROGRAM NAME HERE)
DEPARTMENT OR AGENCY NUMBER
***
CONTRACT ROUTING NUMBER
**_*****
ELIMINATE ALL INFORMATION APPEARING IN RED
LIMITED AMENDMENT FOR TASK ORDERS #*
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 type of entity), whose address or principal place of business is Street
Address, City, State & Zip Code, hereinafter referred to as the "Contractor".
FACTUAL RECITALS
The parties entered into a Master Contract, dated * * * * * * * * **, * * * *, with contract routing
number ** *** ***** "the Master Contract").
Pursuant to the terms and conditions of the Master Contract, the parties entered into a Task Order
Contract, dated ******** **, ****, with contract encumbrance number PO *** **********
and contract routing number ** *** *****, [insert the following if previous amendment(s),
change order(s), renewal(s) have been processed: as amended by] [include all previous
amendment(s), change order(s), renewal(s) and their routing numbers], [insert the
following if previous amendment(s), change order(s), renewal(s) have been processed:
collectively] referred to herein as the "Original Task Order Contract, whereby the Contractor was
to provide to the State the following:
[Briefly describe what the Contractor was to do under the Original Task Order
Contract -indent this paragraph]
[Please choose one of the following four options and delete the other three options not
selected]
The State promises to [choose one and delete the other] increase/decrease the amount of funds
to be paid to the Contractor by ********** Dollars, ($*.**) during the current term of the
Original Task Order Contract in exchange for the promise of the Contractor to perform the
[choose one and delete the other] increased/decreased work under the Original Task Order
Contract.
Page 1 of 5
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 Task
Order 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 other] years/months, ending on ******** **, ****, in exchange
for the promise of the Contractor to perform the [choose one and delete the other]
increased/decreased work described herein.
The State hereby exercises a "no cost" change to the [choose those that apply and delete those
that don't apply] budget, specifications within the Statement of Work, project
management/manager identification, notice address or notification personnel, or
performance period within the [choose one and delete the other] current term of the
Original Task Order Contract or renewal term of the Original Task Order Contract.
NOW THEREFORE, in consideration of their mutual promises to each other, stated below, the
parties hereto agree as follows:
1. Consideration for this Limited Amendment to the Original Task Order 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 Task Order Contract, contract routing number ** *** *****, [insert the
following language here if previous amendment(s), change order(s), renewal(s) have
been processed] as amended by [include all previous amendment(s), change
order(s), renewal(s) and their routing numbers], [insert the following word if
previous amendment(s), change order(s), renewal(s) have been processed, otherwise
delete "collectively"]collectively referred to herein as the Original Contract, which is by
this reference incorporated herein. All terms, conditions, and provisions thereof, unless
specifically modified herein, are to apply to this Limited Amendment as though they
were expressly rewritten, incorporated, and included herein.
3. It is expressly agreed to by the parties that the Original Task Order Contract is and shall
be modified, altered, and changed in the following respects only:
[Please choose one of the following three options and delete the two options not
selected]
A. [Use this paragraph when changes to the funding level of the Original Task
Order Contract occur during the current term of the Original Task Order
Contract] This Limited Amendment is issued pursuant to paragraph 5 of the
Original Task Order Contract identified by contract routing number ** ***
*****. This Limited Amendment is for the current term of ********* **,
Page 2 of 5
EXHIBIT C
****, through and including ********* **, ****. The maximum amount
payable by the State for the work to be performed by the Contractor during this
current term is [choose one and delete the other] increased/decreased by
********** Dollars, $( *.**) for an amended total financial obligation of the
State of ********** DOLLARS, $*.** . [Delete the following sentence if not
applicable in your situation] The revised Statement of Work is incorporated
herein by this reference and identified as "Attachment *". [Delete the following
sentence if not applicable in your situation] The revised Budget is incorporated
herein by this reference and identified as "Attachment *". The Original Task
Order Contract is modified accordingly. All other terms and conditions of the
Original Task Order Contract are reaffirmed.
A. [Use this paragraph when the Original Task Order Contract will be renewed
for another term] This Limited Amendment is issued pursuant to paragraph 5 of
the Original Task Order Contract identified by contract routing number ** ***
*****. This Limited Amendment is for the renewal term of ********* **,
****, through and including ********* **, ****. The maximum amount
payable by the State for the work to be performed by the Contractor during this
renewal term is * * * * * * * * * * Dollars, $( *. * *) for an amended total financial
obligation of the State of ********** DOLLARS, ($*.**). [Delete the
following sentence if not applicable in your situation] The revised Statement of
Work is incorporated herein by this reference and identified as "Attachment *".
[Delete the following sentence if not applicable in your situation] The revised
Budget is incorporated herein by this reference and identified as "Attachment *".
The Original Task Order Contract is modified accordingly. All other terms and
conditions of the Original Task Order Contract are reaffirmed.
A. [Use this paragraph when there are "no cost changes" to the Budget, the
specifications within the original Statement of Work, allowable contract
provisions as noted, or performance period.] This Limited Amendment is
issued pursuant to paragraph 5 of the Original Task Order Contract identified by
contract routing number ** *** *****. This Limited Amendment [choose those
that apply and delete those that don't] modifies the Budget in [identify
location in contract], modifies the Statement of Work in [identify location in
contract], modifies the project management/manager identification in
[identify location in contract], modifies the notice address or notification
personnel in [identify location in contract], modifies the period of
performance in [identify location in contract] of the Original Task Order
Contract. The revised [choose those that apply and delete those that don't]
Budget, Statement of Work, project management/manager identification,
notice address or notification personnel, or period of performance is
incorporated by this reference and identified as. All other terms and conditions of
the Original Task Order Contract are reaffirmed.
4. The effective date of this Limited Amendment is **/**/****, or upon approval of the
State Controller, or an authorized delegate thereof, whichever is later.
Page 3 of 5
5. Except for the Special Provisions and other terms and conditions of the Master Contract
and the General Provisions of the Original Task Order Contract, in the event of any
conflict, inconsistency, variance, or contradiction between the terms and provisions of
this Limited Amendment and any of the terms and provisions of the Original Task Order
Contract, the terms and provisions of this Limited Amendment shall in all respects
supersede, govern, and control. The Special Provisions and other terms and conditions of
the Master Contract shall always control over other provisions of the Original Task Order
Contract or any subsequent amendments thereto. The representations in the Special
Provisions to the Master Contract concerning the absence of personal interest of state of
Colorado employees and the certifications in the Special Provisions relating to illegal
aliens are 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 4 of 5
EXHIBIT C
IN WITNESS WHEREOF, the parties hereto have executed this Limited Amendment on the
day first above written.
CONTRACTOR:
[LEGAL NAME OF CONTRACTOR]
(a political subdivision of the State of Colorado)
By:
Nameā¢
Title:
HEALTH
FEIN:
ATTEST:
Because the Contractor is a governmental
entity, an attestation is required
(Seal, required)
By:
City, City and County, County,
Special District, or Town Clerk or Equivalent
[Delete inapplicable Language.]
By:
ALL CONTRACTS MUST BE APPROVED BY THE STATE CONTROLLER
CRS 24-30-202 requires that the State Controller approve all state contracts. This limited
amendment 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 goods and/or services provided.
STATE CONTROLLER
Leslie M. Shenefelt
By:
Date:
STATE:
STATE OF COLORADO
Bill Ritter, Jr. Governor
By:
For the Executive Director
DEPARTMENT OF PUBLIC
AND ENVIRONMENT
PROGRAM APPROVAL:
Page 5 of 5
Exhibit D
OPTION LETTER
Exhibit
Date: State Fiscal Year: Option Letter No.
SUBJECT: (Choose only one below)
1 -Option to renew only (for an additional term)
2 -Change in the amount of goods within current term
3 -Change in amount of goods in conjunction with renewal for additional term
4 -Level of service change within current term
5 -Level of service change in conjunction with renewal for additional term
6 -Option to initiate next phase in contract
For use with Options #1 - 5: In accordance with Paragraph(s) of contract routing number (FY)
(Agency or
institution of higher education) (Routing #), between the State of Colorado, Department of/or Higher Ed Institution
(agency or
institution of higher education name), (division name), and (contractor's name) the State hereby exercises the option for an
additional
term of (include performance period here) at a cosVprice specified in Paragraph/Section/Provision ,AND/OR an
increase/decrease in the amount of goods/services at the same rate(s) as specified in Paragraph/Schedule/Exhibit
For use with Option #6, please use the following: In accordance with the terms set out in the original contract
(include CLIN routing number, FY, & Agency or institution of higher education) between the State of
Colorado,
Department of/or Higher Ed Institution (agency or institution of higher education name), (division name), and
contractor's
name )the State hereby exercises the option to initiate Phase (indicate which Phase: 2, 3, 4, etc.) for
the term of
(State Performance period) at the cost/price specified in Paragraph/Section/Provision
For use with Options #1 - 6: The amount of the current Fiscal Year contract value is increased/decreased by ($
amount of
change) to a new contract value of ($ ) to satisfy services/goods ordered under the contract for the current
fiscal year
(indicate Fiscal Year). The first sentence in Paragraph/Section/Provision is hereby modified accordingly.
The total contract value to include all previous amendments, option letters, etc. is ($ ).
APPROVALS:
State of Colorado:
Bill Ritter, Jr. Governor
By: Date:
Executive Director/College President]
Colorado Department of/or Higher Ed Institution
ALL CONTRACTS MUST BE APPROVED BY THE STATE CONTROLLER
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 goods and/or services provided.
State Controller
Leslie M. Shenefelt
By:
Date: