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HomeMy WebLinkAboutC09-178 Task Order Waiver #154 (Rtng #10 FAA 00052)~~r~~ DEPr1RTMENT OF PUBLIC HEr1LTH r1ND ENVIRONM~NT ROUTING NO.10 FAA OOa52 '~ APPROVED TASK ORDER CONTRACT - WAIVER #154 This Task Order Contract is issued pursuant to Master Contract made on Ol/23/2007, cvith routing number 08 FAA 0001G STATE: State of Colorado for the use & benefit of the Department of Public Health and Environment Office of Planning and Partnerships 4300 Cherry Creek Dtive South Denver, Colorado 80127 TASK ORDER MADE DATE: 04/30/2009 PO/SC ENCUMBRANCE NUb1BER: PO FAA OLL10000052 TERM: This Task Order shall be effective upon approval by the State Controller, or designee, or on 07/01/2009, whichever is later. The Task Order shall end on 06/30/2010. PRICE STRUCTURE: Fixed Price PROCUREMENT METHOD: Exempt BID/RFP/LIST PRICE AGREEMENT NLb113ER: Not Applicable LA\\' SPECIFILD VENDOR STATUTE: Not Applicable CONTRACTOR: Board of County Commissioners of Eagle County 500 Broadway Eagle, CO 81631-0850 for tlie use and benefit of the Eagle County Public Health Agency 551 Broadway Eagle, CO 81631 CONTRACTOR ENTITY TYPE: Colorado Political Subdivision BILLING STATEMENTS RECEIVED: Not Applicable. STATUTORY AUTHORITY: Not Applicable CONTRACT PRICE NOT TO EXCEED: $ 101,570.00 F~DERAL FUNDING DOLLARS: 4t JP STATE FUNDING DOLLARS: $ 1O1,S7O.OO MA.YIMUM AMOUNT AVAILABLE P~R FISCAL YEAR: FY 10: $ 101,570.00 FI' XX: $ FY XX: $ ~ ~1: $ FY XX: $ STAT~ REPRESENTATIVE: CONTRACTOR REPRESENTATIVE: Kathleen I~Zatthews Rebecca Larson Department of Public Health and Environment Eagle County Public Health Agency Office of Plamung and Partnerships PO Box 660 4300 Cherry Creek Drive South Eagle, CO 81631 Denver, CO 80246 SCOI'E OF \C'OR1<: PYOVide support fox public health services, as established by flie State Board of Health puxsuant to ~25-1-503(1), C.R.S. and in accordance with Secuon ~25-1-512 C.R.S. and Section ~24-75.1104.5 (1.5) (a) (I~~ C.R.S. The district public health agenry shall participate in assessment and planning efforts at the state, regional and local level facilitated by dle Office of Planning and Partnerslups. These effoxts shall include maintainuig and impxoving local capacity to provide services as established by the State Boaxd of Health. Page 1 of 5 Rev 4/3/09 EXHIBITS: 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 Oxder Contsact. These genexal clauses may have been expanded upon ox made more specific in some instances in e~ibits to this Task Oxder Contract. To the extent that other pxovisions of this Task Order Contract provide more specificity than these general clauses, the more specific pxovision 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 ali work shall be performed according to the standards, terms and conditions set forth in the Mastei: 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 Cont~•act 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 inclnding the date specified on page one of this Task Order Contrack, unless sooner terminated by the parties pursuant to the terms and conditions of this Task Order Contract andlor 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 Conti•act. 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 ContracC 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 Page 2 of 5 Rev 4/3/09 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; 4) the Additional Provisions -_E~ibit A, and its attachments if included, to this Task Order Contract; 5) the Scope/Statement of Wark - E~ibit 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 "E~ibit B". The State, with the concui•rence 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 E~ibit 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. 7. STATEWIDE CONTRACT MANAGEMENT SYSTEM [This section shall apply when the Effective Date is ori or after July 1, 2009 arzd the rnaximum aniount payable to Contractor hereunder is $100,000 or higher] By entering into this Task Order Contract, Contractor agrees to be governed, and to abide, by the provisions of CRS §24-102-205, §24-102-206, §24-103-601, §24-103.5-101 and §24-105-102 concerning the monitoring of vendor performance on state contracts and inclusion of contract performance information in a statewide contract management system. Contractor's performance shall be evaluated in accordance with the terms and conditions of this Task Order Contract, State law, including CRS §24-103.5-101, and State Fiscal Rules, Policies and Guidance. Evaluation of Contractor's performance shall be part of the normal contract administration process and Cohtractor's performance will be systematically recorded in the statewide Contract Management System. Areas of review shall include, but shall not be limited to quality, cost and timeliness. Collection of information relevant to the performance of Contractor's obligations under this Task Order Contract shall be determined by the specific requirements of such obligations and shall include factors tailored to match the requirements of the Statement of Project of this Task Order Contract. Such performance information shall be entered into the statewide Contract Management System at intervals estabiished in the Statement of Project and a final review and rating shall be rendered within 30 days of the end of the Task Order Contract term. Contractor shall be notified following each performance and shall address or correct any identified problem in a timely manner and maintain work progress. Should the final performance evaluation determine that Contractor demonstrated a gross failure to meet the performance measures established under the Statement of Project, the Executive Director of the Colorado Department of Personnel and Administration (Executive Director), upon request by the Colorado Department of Public Health and Environment and showing of good cause, may debar Contractor and Page 3 of S Rev 4/3/09 prohibit Contractor from bidding on future contracts. Contractor may contest the final evaluation and result by: (i) filing rebuttal statements, which may result in either removal or correction of the evaluation (CRS §24-105-102(6)), or (ii) under CRS §24-105-102(6), exercising the debarment protest and appeal rights - provided in CRS §§24-109-106, 107, 201 or 202, which may result in the reversal of the debarment and reinstatement of Contractor, by the Executive Directoi•, upon showing of good cause. Page 4 of 5 Rev 4/3/09 THE PARTIES HERETO HAVE EXECUTED THIS CONTRACT ~ Persons signing for Contractor hereby swear and af~rm that they are authorized to act on Contractor's behalf and acknowledge that the State is relying on their representations to that effect. CONTRACTOR: STATE OF COLORADO: Board of County Commissioners of Eagle County BILL RITTER, JR. GOVERNOR For the use and benefit of the Eagle County Public Health Agency Legal Name of Contracting Entity By For Executive Director r- Department of Public Health and Environment Signature of Autho 'zed O~cer Print Name of A orized O~cer Signatory avers to the State Controller or delegate that Contractor has not begun performance or that a Statutory ~olation waiver has been requested under Fiscal Rules ~ ~~~1-~'~ 1 Ii.l~t~ Print Title of Authorized Officer Department Program Approval: sy ALL CONTRACTS MUST BE APPROVED 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. ff 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 J. McDermott, CPA By Date Page 5 of 5 Rev 4/3/09 Attachment B-1 Eagle County Public Health Agency Statement of Work and Budget The Office of Planning and Partnerships desires to strengthen the capacity to provide public and environmental health services in Colorado. This scope of work is designed to: 1. Provide accountability to assure State monies are being used effectively to provide public health services. 2. Develop and maintain a consistent planning framework that integrates local public health planning with statewide public health planning. 3. Inform state level decisions and policy development by integrating county and district public health plans with CDPHE strategic planning. ' 4. Build state and local partnerships focused on strengthening Colorado's public health system. 5. Identify areas in the state system that need improvement to better support county and district agencies through the state system functions of 1) Planning and Implementation; 2) Technical Assistance and Support; 3) Evaluation and Quality Improvement; and 4) Resources. It is hereby agreed that for and in consideration of their mutual promises to each other, hereinafter stated, the parties hereto agree as follows: 1. Public Health Services. The county or district public health agency sha11 use these moneys to provide support for public health services, as established by the State Board of Health pursuant to §25-1-503(1), C.R.S. and in accordance with Section §25-1-512 C.R.S. and Section §24-75.1104.5 (1.5) (a) (IV) C.R.S. A copy of the current definition of Basic and Optional Services shall be posted at the Office of Planning and Partnerships website. 2. Statewide and Countv/District Public Health Plannin~. The county or district public health agency shall participate in assessment and planning efforts at the state, regional and.local level facilitated by the Office of Planning and Partnerships. These efforts shall include maintaining and improving local capacity to provide services as established by the State Board of Health. 3. Renorts and Audits. The contractor shall provide to the State an agency annual report for the previous calendar year to be submitted by April l, 2010. A template shall be provided on the Office of Planning and Partnerships website by January l, 2010. The quarterly advance of funds for the period April, May and June of the current fiscal year shall be withheld until all reports are received by the State. The contractor shall maintain such records as may be necessary to provide the information herein required by the State and submit to such reasonable audits and evaluations as may be necessary. 4. 5upplantin~ of Funds. In order to qualify each county and city and county shall comply with the statutory requirements for contribution as set forth in C.R.S. § 25-1-512 for its local health services. Each board of health may contribute such additional amounts as it inay determine to be necessary to meet their local health needs. 5. Payment. Payment equal to (1/4) of the total allocation shall be paid automatically in the last month of each quarter as follows: Page 1 of 2 Quarter Amount July 1 through Se tember 30, 2009 $ 25,392.00 October 1 throu h December 31, 2009 $ 25,392.00 January 1 through March 31, 2010 $ 25,392.00 April 1 through June 30, 2010 $ 25,394.00 Page 2 of 2 EXHIBIT A ADDITIONAL PROVISIONS To Task Order Contract Dated 04/30/2009 - Contract Routing Number 10 FAA 00052 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 shali 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 5tate 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. 5. 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 te~~ms 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 v1.0 (11/OS) contract template EXHIBIT B STATEMENT OF WORK To Task Order Contract Dated 04/30/2009 - Contract Routing Number 10 FAA 00052 These provisions are to be read and interpreted in conjunction with the provisions of the Task Order Contract specified above. 1. The Contractor, in accbrdance with the terms and conditions of this c.ontract, shall perform and complete, in a timely and satisfactory manner, all activities described in the approved Statement of Work and Budget that is attached hereto as Attachment B-1 and incorporated herein. 2. The Contractor will be required to submit reports as required and outlined in the statement of work, Attachment B-1. To be attached to CDPHE Page 1 of 1 Revised: 12/19lQ6 Task Order v1.0 (11/OS) contract template EXHIBIT C DEPARTMENT OR AGENCY NAME COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT ADD DIVISION-PROGRAM ACRONYMS DEPARTMENT OR AGENCY NUMBER >;C>;C>;C CONTRACT ROUTING NUMBER ~ *x~x&x~%F ELIMIN~ITF. ALL INPORMATIC?N APPEARING IN RED LIMITED AMENDMENT FOR TASK ORDER5 #~ 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 Cherrv Creek Drive South, Denver, Colorado 80246, hereinafter referred to as the "State"; and, LEGAL NAME OF ENTITY, (legal tvpe of entitv), whose address or principal place of business is Street Address, Citv, State & Ziu Code, hereinafter referred to as the "Contractor". FACTUAL RECITAL5 The parties entered into a Master Contract, dated ***~~`~`~`* *'~ ~~"~`*, with contract routing number *~ "** """** Pursuant to the terms and conditions of the Master Contract, the parties entered into a Task Order Contract, dated *"~~~`*"* ~`~` *"~"` with contract encumbrance number PO *"~` *""*~`~`~`x"~ and contract routing number "* *~`* "'~`*"'~`, [insert tlie following if previous amenciinent(s), change order(s}, renewai(s) l~ave been processect: as amended by] [inclt-de all previous amendittent(s), change order(s}, rene~val{S} a~~d tl~eir roziting t~umbers], [insert tl~e following if pre~io~is amendme~zY(s), change orcler(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: [I3riefly describe wl~at tlie Cantractar was to do under the Original Task Order Contract - indent this paragraph] ~ [Please choose a~ie of the following four options and deIete the other three options not setectecl] 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 tlie other] inereased/decreased work under the Original Task Order Contract. The State promises to pay the Contractor the sum of ~"~*''""~"""` Dollars, *.x* in exchange for the promise of the Contractor to continue toperform the work identified in the Original Task Order Contract for the renewal term of """'~` years/months, ending on *xx*"'~`*" "~, *"** The State promises to [chaose a~ie and delete the oCher] increase/decrease the amount of funds to be paid to the Contractor by '~"""""""~`xx Dollars, "."* for the renewal term of """" [choose ane and deiete the other] years/months, ending on x~~'~"•""`* ~"~`, ~*'~"`, in exchange for the promise of the Contractor to perform the [choose one ancl delete tlie atlier] increased/decreased work described herein. The State hereby exercises a"no cost" change to the [choose those that api~ly ar~d delete those that clon't appI3=] budget, specifications within the 5tatement of Work, project managemenbmanager identification, notice address or notification personnel , or performance period within the [etioose one and delete the otlaer] current term of the Original Task Order Contract or renewal term of the Original Task Order Contract. Page 1 of 4 Rev 4/3/09 EXHIBIT C 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 Task Order Contract consists of the payments and services that shall be made pursuant to this Limited Amendment, and promises and agreements herein setforth. 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 fallowing language here if previous amendmeirt(s), change order(s}, renewal(sj have been processed] as amended by [include ail previous amendmec~t(s), cl~ange order(s), renewal(s) and their routing marnbers], [insert tl~e following ward if previous a-neitd~nent(s), change order(s}, renewal(s) have been processed, other~vise delete "callectively"]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 rewritte.n, incorporated, and included herein. 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 ctioose one of the followiizg three aj}tions and delete the t~~o aptions not selected] A. [Use this paragraph ~rhen changes to tl~e fi~nding tevel of the Origiual Task Order Contract occur during tlie curreut te-•m 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 '~`~ *X~ *****. This Limited Amendment is for the current term of ""**~'~*"* '~'~` "**" through and including '~~"'~~`*"~`~` ** *~`**. The maximum amount payable " by the State for the work to be performed by the Contractor during this current term is [cl~oose one and delete the other] increasedldecreased by **"*~`***** Dollars, '~."~` for an amended total financial obligation of the 5tate of *""*"~=*"'~* DOLLARS, (~`."*). [Delete the following sex~tence if not app[icable in your situatiou] The revised Statement of Work is incorporated herein by this reference and identified as "Attachment '~". [nelete the following sentence if not a~~plieable in your situatian] 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 ~arag-•aph wleen the Original Task ~rder Contract Evi11 be rene«-ed far a~~otliei- 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 *~`*""'~"** *", "x~~` 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 xx*'~x**xxX DOLLARS, ($'•`.M'~). [Delete the foliowing sentence if nat agplicable in your siti~atian] The revised Statement of Work is incorporated herein by this reference and identified as "Attachment *". [Delete the follo~~ing sentence if not applicable ,iu 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 reaffi;•med. A. [Use this paragraph 4vt~en Xhere are "no cosE chai~ges" to the Ba~lget, the speci~cations ~vithin the origii~al State~~ient of Work, allowable cantract provisions as noted, or perforniance perioci.] This Limited Amendment is issued pursuant to paragraph 5 of the Original Task Order Contract identified by contract routing number ** *** "****. This Limited Amendment [cl~oose those that apgly and detete those ttiat don't] modifies the Budget in [ide~ttify location in contract], modifies the Statement of Work in [identif,y lncation in Page 2 of 4 Rev 4/3/09 EXHIBIT C contract], modifies the project managementlmanager identification in [identify lacation in. co~atract], modifies the notice address or notification personnel in [identif,y (acation ii~ cantract], modi~es the period of performance in [identif,y location in coi~tract] of the Original Task Order Contract. The revised [cl~oose tiiase tl~at apply ai~d delete those that cio~i't] Budget, Statement of Work, project management/manager identi~cation, notice address or notification personnei is incorporated by this reference and identified as Exhibit " or Attachment *-~`. [If you are cliai~ging the ~e~~far-nance period, clioose the following two se~~teaices or delete both sentenees] The period of performance of the [cl~oose one and delet.e tlie ather] current/renewal term is hereby [choose ane and delete tlie otl~er] extended/reduced by "'~`*'~" ('~) months, changing the current ending date from "'~`x""'~`*"" "" """~ to "*"*'~`x'~** "" "x"'~` The revised period of performance is ""~""""""` "* "'•""` through and including """"""',`*x ~x xxxx The Original Task Order Contract is modified accordingly. All other terms and conditions~ of the'Original Task Order Contract are reaffirmed. The effective date of this Limited Amendment is **""***'~` "'~` '•`*'~"`, or upon approval of the State Controller, ar an authorized delegate thereof, whichever is later. 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 Conri•act shall always control over other provisions of the Original Task Order Contract or any subsequent amendments thereto. The representations in the 5pecial 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. 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 Rev 4/3/09 EXHIBIT C IN WITNESS WHEREOF, the parties hereto have executed this Limited Amendment on 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. CONTRACTOR: [LEGAL NAME OF CONTRACTOR] (Legal type of entity) Signature of Authorized Of~cer Print Name of Authorized Of~cer Print Title of Authorized Officer 5TATE: STATE OF COLORADO Bill Ritter, Jr. Governor By: For the Executive Director DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT Signatory avers to the State Controller or that Contractor has not begun performance or that a Statutory Violation waiver has been requested under Fiscal Rules PROGRAM APPROVAL: By: ALL CONTRACTS MUST BE APPROVED 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. 5TATE CONTROLLER David J• McDermott, CPA By: Date: Page 4 of 4 Rev 4/3/09 EXHIBIT D SAMPLE OPTION LETTER Date: State Fiscal Year: O tion Letter No. CLIN Routing # 1) OPTIONS: Choose all applicabie options listed in §1 and in §2 and delete the rest. a. Option to renew only (for an additional term) b. Change in the amount of goods within current term c. Change in amount of goods in conjunction with renewal for additional term d. Level of service change within current term e. Level of service change in conjunction with renewal for additional term f. Option to initiate next phase of a contract 2) REQUIRED PROVISIONS. Ali Option Letters shall contain the appropriate provisions set forth below: a. For use with Options 1(a-e): In accordance with Section(s) of the Original Contract routing number between the State of Colorado, Department of Public Health and Environment, and Contractor's Name, the State hereby exercises its option for an additional term beginning Insert start date and ending on Insert ending date at a cosUprice specified in Section , AND/OR an increase/decrease in the amount of goods/services at the same rate(s) as specified in Identify the Section, Schedule, Attachment, Exhibit etc. b. For use with Oation 1(f), please use the followinq: In accordance with Section(s) of the Original Contract routing number between the State of Colorado, Insert Name of Department or Higher Ed Institution , and Contractor's Name, the State hereby exercises its option to initiate Phase indicate which Phase: 2, 3, 4, etc for the term beginning Insert start date and ending on Insert ending date at the cost/price specified in Section . c. For use with all Options 1(a-f): The amount of the current Fiscal Year contract value is increased/decreased by $ amount of change to a new contract value of Insert New $ Amt to as consideration for services/goods ordered under the contract for the current fiscal year indicate Fiscal Year. The first sentence in Section is hereby modified accordingly. The total contract value including all previous amendments, option letters, etc. is Insert New $ Amt. $ 3) Effective Date. The effective date of this Option Letter is upon approval of the State Controller or , whichever is later. STATE OF COLORADO Bill Ritter, Jr. GOVERNOR Department of Public Health and Environment By: Lisa Ellis, Purchasing & Contracts Unit Director Date: ALL CONTRACTS REOUIRE 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 performipg 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 J. McDermott, CPA By: Donald Rieck Date: ~I Page 1 of 1 Effective Date: 1/6/09 TERM SHEET - ( t~1 ~~ ~ ~ ~~~ ~ 1) Re uested hearin date: First choice Second choice ~~ 2) For Countv Manager signature: NO / 3) Requestin~ department: Public Health ~ 4) Title: Colorado Department of Public Health and Environment ask O er Contract - Waiver #154 pursuant to Master Contract made on Ol/23/2007. 5) Check one: Consent: X On the Record: 6) Staff submitting: Becky Larson, Co-acting Public Health Manager 7) Purpose: This Task Order, from the Colorado Department of Public Health and Environment, provides funds for the Eagle County Department of Public Health to support community health assessment, planning, and accountability efforts at the state, regional and local health agency level. This includes maintaining local public health capacity to provide core public health services as established by the State Board of Health. This funding is allocated towards staff time of nurses, health educator, and epidemiologist/health planner. 8) Schedule: The task order is for the time period July l, 2009 - June 30, 2010. 9) Financial considerations: This Task Order is for a total of $101,570 during state fiscal year 2009. Payment equal to (1/4) of the total allocation shall be paid automatically in the last month of each quarter: An annual report is required to receive the last quarter funds. 9) Other: ~'' c ~ ~~ . ~~, ,~~``~ ;J ,~~ ' ,f . ~v f ~ ,/ l~`~ ~~ t ~'~~'~~ ~:~~~~t l ~~, t~~~ , f` s't;i ~V` l~ . ~ ~~ ~ ~~ PR S TQ F By: E~gi~ C~untty ~~tc~~nney's ~ffice ~y: ~~~I~ ~s~unty Commi~sioners' 4ft)te Please retu~•~t executed contract and copies to Ky~n Iglesias i~a HHS. 970-328-8847.