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HomeMy WebLinkAboutC16-008 Northwest Colorado Council of Governments Alpine Area Agency on AgingPURCHASE OF SERVICES CONTRACT TITLE III OF THE OLDER AMERICANS ACT and STATE OF COLORADO OLDER COLORADANS ACT NORTHWEST COLORADO COUNCIL OF GOVERNMENTS ALPINE AREA AGENCY ON AGING 249Warren Avenue; pO Box 2309 Silverthorne, CO g049g_230g ('NWCCOG") and EAGLE COUNTY, COLORADO through itsPUBLIC HEALTH AND ENVIRONMENT DEiARTMENT PO Box 660 Eagle, CO 81631 ("coNTRACTOR") CONTRACT # 1Gt17-Fy Eagte PHED FEDERAL ID NUMBER 84.6000762 l I A. RECITALS: The Alpine Area Agenly onAging, a program of the NWCcoG, is mandatedunder the provisions of the Older Americlns Act ("OAA") and the State Fundingfor senior services ('sFSs") (referred to collectiv'et/as ;onn,srss,; to rori",'the- development and implementation of compreh"ri.iu" and coordinated servicedelivery system to secure and maintain maximum independence and oigniiy fo,.older adults. NWCCOG is the recipient of funds under the OAA/SFSS. The NWCCoG desires to enter into this contract with Contractor to provide certainservices and programs, which is expected to be financeo fartiatty under oAA/SFSS,in the Region 12 Planning and service Area: Eagle, orani, u"ckson, pitkin, andSummit Counties (the "Contract,'). The Contractor is accountable to the NW.CCOG for using funds obtained through this Q91!ract appropriately in the delivery of the services ror6toer adults and othereligible individuals. The Contractor agrees-to comply with all relevant provisions of the signed contractbetween the NWCCoG and the State of Colorado, in"oipor"ted here-in uy refeience B. c. Purchase of Services Contract OAA/OCA :,i ' : iiii,;,:, E. C16-008 and made a partof this Contract, as if fullysetforth, in the monitoring andadministration of this Contract. F The NWCCoG and the State are authorized to monitor the Contractor's use andmanagement of these funds and to review the Contractor's compliance with law,policies, audit requirements, contract requirements, and State policy Oirectives. NoW THEREFoRE, NWccoG and Contractor (collectively referred to herein as the"Parties") mutually agree as follows: 1.0 SELECTION OF CONTRACTOR NWCCOG hereby selects the Contractor and the Contractor hereby agrees to perform theservices hereinafter set forth in connection with the project of NWCCOIG anoi6e AlpineArea Agency on Aging under the OAA/SFSS. 2.0 SCOPE OF SERVICES Contractor shall do, perform, and carry o.ut,in a satisfactory manner, as determined byNWCCOG' all work elements described in Contractor's Proposal submitted for funding (asapproved and as may be amended, from time to time, oy trt'iluccoG) which is rrereinincorporated by reference and made a part of this Contract and which is summarized inExhibit A of the Contract. 3.0 INDEPENDENT CONTRACTOR Contractor agrees and understands that Contractor is an independent contractor providingservices to the NWCCOG. Nothing in the Contract shall be deemed to make Contractor anagent, employee, partner or representative of the NWCCOG. 3'1 Contractor shall not have the authority to bind the NWCCOG to any agreement,liability or understanding, without the written consent of NWccoG. 3'2 At all times during the term of the Contract, Contractor shall (i) provide and keep inforce workers' compe.nsation and unemployment ;"rt;;.;iion insurance in the amountsrequired by law, and (ii) be solely responsible for its acts and those orits emplolees andagents. 4.0 COMPLIANCE Contractor shall perform such services in compliance with all provisions and covenants ofthis Contract, including but not limited to compliance with all applicable statues, rules,regulations, covenants, conditions or stipulations governing the'servic""i;;; ;;ovided. 4.1 Conformance with Laws Co.ntractor agrees to comply with all applicable laws, rules, regulations, and ordinances offederal, state and local government authorities have jurisdi"tion ou"r Contractor or any ofthe contract work, or activities carried out in the name of or on behalf of NWCCOG. NWCCOG-Alpine Area Agency on Aging Revised 12.01 .2015 Purchase of Services Contract OAA/OCA Contractor shall obtain, at its ow'n expense, all permits, licenses, and equipment required ofit by such authorities to enable contractor to engage in the contract work. 4'2 compliance with Program policies and service standards Contractor shall comply with applicable program policies and standards. Services shall beimplemented according to these standards, unless the State has granted a waiver ofcompliance. Applicable Federal and State laws, rules, regulationJ and standards are listedin Exhibit B of the Contract. 5.0 ADMINISTRATIVE REQUIREMENTS contractor shall comply with all applicable provisions of 45 cFR, Part 74 and 45 cFR part 92 regarding uniform requirements for the administration of U.S. Department olHealth andHuman Serviceg (HHS) grants and principles for determining costs applicable to activitiesassisted by HHS grants. 6.0 PERIOD OF PERFORMANCE NWCCOG intends to issue the Contract on a state fiscal year period (July-June). The initialterm of the contract begins on January 1 ,2016 and ends on June go, zoio "nd, uponissuance by NWCCOG of an Extension Letter for the first fiscal year, commencing on July1,2016 and ending June 30, 2017. Services shall be undertaken in such sequence as toassure completion of all services required hereunder by June gO, 2017. Contractor shallnot begin services prior to execution of the Contract. The Contract may be considered for renewal, upon execution by NWCCOG of an OptionLetter, for twelve-month terms through June 30, 2019. Annual renewal of the Contract iscontingent upon availability of funds, continuation of state/federally funded programs, annualArea Plan relriew, Contractor performance/compliance, an-d organizatio-nal opiions Lor delivery of specified contracted services. Example Option Letter islttached hereto asExhibit G. 7.0 AMOUNT OF CONTRACT NWCCOG agrees to reimburse Contractor for allowable project expenses up to but notexceeding the amount of $ 98,896.00 shown in the attached- Exhibit A. 7 '1 The match from the Contractor shall consist of the sum total for Local Cash and/or InKind in the amount of g 24,356.01 shown in the attached Exhibit A. The Contractorstipulates that the specified cash or in-kind contributions have not been nor will they beused to satisfy or match any other Federal or State grants or funds. Valuation of in-kindmatch shall show how the in-kind match was compuied, and must be incorporated intoContractor's accounting records. Supplies, volunteer services, and other contributions shallbe valued as described under 45 CFR, part74, Subpart C. 7 '2 The Contractor estimates there will be $ 23,250.03 in program income/client contributions shown in the attached Contract Reimbursemeni Syltem document, Exhibit A. NWCCOG-Alpine Area Agency on Aging Revised 12.01 .2015 Purchase of Services Contract OAA/OCA 8.0 U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICERS ("HHS'') GRANT 8'1 The Parties agree the if HHS or the State disapprove of the Contract or refuse or failto make the grant to NWCCOG as contemplated by the Contract, then the Contract shall bevoid and shall not be binding on any parties hereto. Unearned payments under the Contractmay be suspended or terminated in the event that Contractor refuses to accept additionalterms or conditions to this Contract that may be imposed by HHS, the State or NWCCOGafter the effective date of the Contract. 8.2 Contractor expressly acknowledges that Contractor will be paid or otherwisecompensated with funds provided to NWCCOG by federal agencies that are subject tosequestration pursuant to the Budget Control Act of 2O11 aid other applicable federal laws.lf funds for the Contract are not advanced, or are diminished, or returned to the federalgovernment due to sequestration, NWCCOG may immediately terminate the Contract inwhole or part without liability, including costs and liability for termination. Contractorexpressly acknowledges and agrees that NWCCOG hai the right to require that fundspreviously paid to Contractor for services performed hereundei be returned to NWCCOG inthe event the federal government requires that funds be returned because of sequestration 9.0 CHANGES 9.1 Except as may.be_expressly provided in the Contract, any changes, including anyincrease or decrease in the amount of the Contract or changes in the s-cope of services, thatare mutually agreed upon by NWCCOG and Contractor, shlll be incorporated in a writtenOption Letter or a written amendment to the Contract. 9.2 lf there is any increase or decrease in the amount of OAA/SFSS funding received byNWCCOG which directly or indirectly affects Contractor's compensation paid h-ereunder,NWCCOG shall give written notice to Contractor and said notice and the'comfensation paidthere under shall become an amendment to the Contract. 1O.O REIMBURSEMENTMETHOD Contractor shall submit a monthly services report and reimbursement request on a formprescribed by NWCCOG or systems for services performed and expenses incurred withinthat month. Such report and request shall be filed on or before the fifteenttr lisgry day ofthe following month in which services are provided, throughout the term of the Contract. Failure to submit the monthly report and reimbursement request by the fifteenth day of thefollowing month will delay processing of payments until the next cilendar month. Further, failure to submit the final month's report and reimbursement request by July 15 ofthe then-current fiscal year of the contract term, will result in non-payment for servicesprovided, and Contractor specifically agrees that any such late-filed flnal reimbursementrequest will not be paid. Contractor is responsible for the timely filing, completeness and accuracy of all service Pe{gnTge reports and reimbursement requests. All payments are subject to verificationby NWCCOG. NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA 11.0 ERRONEOUSPAYMENTS. Unless prohibited by Federal or State law or regulation, any costs incurred by theContractor that are later found to be disallowed-or ineligible for payment undlrthe Contractshall be reimbursed by the Contractor to NWCCOG, oioffset against current or futurepayments due by NWccoG to the contractor, at NWCCoG's Jlection. 12.0 TERMS AND GONDITIONS To tfe 9xte1t possible, llre laltieg agree that this contract is also subject to the provisionsset forth in Exhibits A, B, c, D, E, F, and G of the contract, attached hereto andincorporated. 13.0 CANCELLATION OR TERMINATION 13.1 Termination of Contract for Cause lf, through any cause, Contractor fails to fulfill in a timely and proper manner Contractor,sobligations under the Contract, or if Contractor violate" Lny oi ftre "ou"n"nt", agreements,or stipulations of the Contract, NWCCOG shall thereupon -h"ue the right to terminate thepontlac! by giving written notice to Contractor of such termination, th6 reasons for suchtermination, and specifying the effective date of termination. Notice of termination of theContract shall be mailed by Certified Mail,-return receipt requested, at least thirty (30)calendar days prior to the effective date of termination, unless a shorter time is set forthherein for any failure to fulfill Contractor's obligations. 13.2 MutualTermination The parties may mutually terminate the Contract upon consent by both parties by preparingand executing a written notice of intent to terminate the Contract a minimum of thirty (30)caiendar days prior to the effective date of termination. The written notice shall include theeffective date of termination and the reason(s) for terminating the contract. 13.3 Termination By Contractor Contractor may terminate the Contract by submitting a written notice to NWCCOG no lessthan.thirty (30) days prior to the termination date "eiting fortfr tfre reasons for suchtermination and specifying the effective date of terminaiion. Contractor shall mail the writtennotice of termination to the NWCCOG by Certified Mail, return receipt requested. lfContractor terminates a portion of the Contract, NWCCOG, at its opiion may teiminate theContract in its entirety. 13.4 Liability Unless otherurrise herein, the contractor shall not be relieved of liability to NWCCoG fordamages sustained by NWCCoG because of any breach of the Contiact oy te contractor,and NWCCoG may withhold any payments to the Contractor for the purposaoi setoff untilsuch time as the exact amount of damages due to NWCCOG from the iontractor isdetermined 13.5 Project Material In the event of termination, all finished or unfinished documents, data, studies, surveys,drawings, maps, models, photographs, and reports or other material prepared by thl Contractor NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA under this Contract shall, at the option of NWCCOG, become its property, and the Contractorshall be entitled to receive just and equitable compensation for any satis'factory work completedon such documents and other materials. 14.0 REMEDIES a' NWCCOG, at its discretion, may terminate the Contract in accordance with 13 if contractor violates or breaches any terms of the contract. b. NWCCOG may also institute any available administrative, contractual, orlegal remedies available to NWCCOG as may be appropriate, and may take one ormore of the following actions, as appropriate:(1) Temporarily withhold payments pending correction of deficiency by theContractor. (2) Disallow all or part of the cost of the activity or action not in compliance. (3) Whoty or partly suspend or terminate the Contract, including suspending the Contract and services provided under the Contract penling anyaudit or other investigation. (4) Withhold further Contracts with Contractor. (5) Take any other remedies that may be regaily avairabre. 15.0 CORREGTIVE ACTION ln the event the NWCCOG finds that Contractor is failing to conform to the terms andconditions of the Contract, the NWCCOG in its sole disc-retion, and in addition to any otherremedies it may have,,may require that the Contractor prepare and comply with a correctiveaction.plan by a specific date, and suspend further payments pending satisfactory compliance by Contractor. Upon issuance of notice to Contractor and without necessity ofan Option Letter or contract amendment, the NWCCOG shall have the right to ietain othercontractors and reallocate funds remaining under the Contract in the eve-nt of termination, orfailure of Contractor to provide the service units listed in Exhibit A in accordance with theContract or a corrective action plan. Nothing in this subsection shall require that theNWcCoG accept a corrective action plan in lieu of exercising its rights io terminate theContract. NOW THEREFORE, with regard to the Contract, NWCCOG and the Alpine Area Agency onAging shall: 1. Monitor and evaluate program performance; 2. Perform program on-site evaluations, as required; 3. Disburse funds in a timely manner, as available; 4. Provide training, technical assistance, and services-related training to Contractor, asavailable: NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA 5' Be accountable for the dissemination and implementation of required policies andprocedures to Contractor and applicable subcontracted service providers within sixty(60) days or within the timeframe as directed by the state Unit on Aging; and 6. Work cooperatively with Contractor to ensure that OAA/SFSS funds are usedappropriately. All Attachments as referenced below are to be provided by the Contractor with thesigned copy of the Contract. E G o| orad o G erti ri ca," .tt:tt?1:l1T"tno,".n p rorit p rovi d ers o n r y) ATTACHMENT B El Gommercial General Liability Insurance NWCCOG and State of Colorado named is Additional Insured El worker's Gom pen "",i."1T*;,:Htt i"bi |ity I n su ran ce coverase ATTACHMENT Dfl Automobile Liability Insurance NWCCOG and State of Colorado named as Additional Insured g proress'""", tflllfi;i,i::H: (as appricabre) ATTACHMENT F E Privacy Liability/Gyber Risk Insurance (for providers managing Protected Health Information of clients) Et Guest Fee Garcur"r,l]H:ltirt"T''|r3" Mear services onry) By signing the Contract, Contractor certifies that the firm, its employees, its principles orauthorized subcontractors are not presently suspended, debarred, proposed for debarment,declared ineligible, or voluntarily excluded irom participation in the bontract oy any federaldepartment or agency. lN WITNESS WHEREOF, the parties hereto have executed this Contract on the31't dayof December ,2015. NWCCoG-Alpine Area Agency on Aging purchase of services contract oAA/ocARevised 12.01.2015 NORTHWEST COLORADO COUNCIL OF GOVERNMENTS [Federat tD No. A4-06SggO6JALPINE AREA AGENCY ON AGING IBy: k=-nl*"'--. Liz Mullen Executive Director EAGLE C By: Ch*,rL NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contracl OAA/OCA EXHIBIT A SCOPE OF SERVICES Contract Number 16117-FY Eagle PHED A.1 Service Budget Compensated Services:service(s) Amount Localcash In-KindTransportation -$ze,ffil Tro,gsag+ Congregate Meals $57,229 $11,155.19 Home Delivered Meal $12,990 $2,245.99 Non-Compensated Services: OUTREACH NUTRITION OUTREACH A.2 Geoqraphic Area The Contractor shall perform all the necessary services provided under this Contract for eligible primary residents of the jurisdiction(s) listed in A.3 service provision. A.3 Service Provision The Contractor shall provide the services described herein. Summary of Units Provided COMPENSATED SERVICESService Service Area(s) Units/MeasurementTransportation Za62 one-way trips Congregate Meals 6,gg0 meals Home Delivered Meal Eagle county (all) 1,1+t meals NWCCoG-Alpine Area Agency on Aging purchase of services contract oAA/ocA Revised 12.01.2015 A1 EXHIBIT B APPLICABLE LAWS, RULES, REGULATIONS, AND STANDARDS As required in the contaict between NWCCOG and the State, the NWCCOG, the Contractorand its agent(s) shall at all.times during the contract period sirictly adhere to ine applicaoreFederal and State laws, rules, and regulations, as they currently exist and may heieafter beamended, which documents are incorporated herein by this reference: 8.1. "Conformance of Larr/' requirement set forth at Paragraph P, of the State of ColoradoDepartment of Human services contract Generar provisioni: ' Age Discrimination Act of 1975,42 U.S.C. Section 6101- and its implementing regulation, 45 C.F.R. part 91;- Age Discrimination in _Employment Act of 1g67,29 u.s.c. 621 et seo.;- Americans with Disabirities Act of 1990 (ADA), 42 u.s.c. rztoGJeq.;. The Drug Free Workplace Act of 1ggg,41U.S.C. 701 et seq.;- Equal Pay Act of 1963, 29 U.S.C. 206;. Health Insurance Portability and Accountability Act of 1996,42 U.S.C. g 1320d etseq. and.implementing regulations, 45 c.F.R. parts 160 and 164;- lmmigration Reform and controrAct of 1986, g u.s.c. 1324b;' Section 504 of the Rehabilitation Act of 1973,29 U.S.C. 7g4, asamended, andimplementing regulation 45 C.F.R. pa,tg4i- Titles vl & vil of the civit Rights Act of 1964,42 u.s.c. 2oo0(d) & (e);' The Personal Re_sponsibility and Work Opportunity Reconciliation nci of 1g96,42usc 604a, PL 104-193. see also state Executivebrder D 01s 00;' The Uniform Administrative Requirements for Grants and Cooperative Agreementsto state and Local Governments (common Rule), at 45 cFR, partg2; ' The Uniform Administrative Requirements for Awards and Sub-awards to Institutionsof Higher Education, Hospitals, Other Non-Profit Organizations, and CommercialOrganizations (Common Rule), at 2 CFR 215: ' Office of Management and Budget Circulars A-87, A-21 or A-122, and 4-102 or A-110, whichever is applicable. ' Office of Management and Budget Guidance for Grants and Agreements 2 CFR part 200. ' The Hatch Act (5 USC 1501-1508) and Givil Service Reform Act, public Law 95-454Section 4728. ' Departments of Labor, Health and Human Services, and Education and RelatedAgencies Appropriations Act, 1990, pL 101_166, Section 511.' 45 CFR Subtitle A, Department of Health and Human Services regulations.' Jhe Single Audit Act Amendments of 1996, 31 USC 7501, publicia* 104-156, OMBCircular A-133, and 45 CRF 74.26. ' The Federal Funding Accountability and Transparency Act of 2006 (public Law 10.9- 282), as amended by $6062 of Public Law 110- 252, including wittnout limitationall data reporting requirements required thereunder. This ActTs also referred toas FFATA. B'2. "Exhibit A, Statement of Work" of the State of Colorado Department of Human ServicesSection ll, References:. Federal Older Americans Act;. code of Federar Reguration (cFR), Tifle 45 pubric werfare:. Older Coloradans Act, C.R.S. 26-11-1OO.1et se+; NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA B1 C.R.S. Title 25 Health and 26 Human Services Code; Colorado Long-Term care om@6-11.5 et seq.; Colorado Department of Human Services Staff Manual Volume 10i Administration on Aging Fiscal Guide, olderAmericans Act, Tifles lll and Vll; Colorado Retail Food Establishment Rules and Regulations; Dietary Guidelines for Americans; Dietary Reference Intakes (DRls); SUA Policy and Procedures Manual; SUA Policy Directives; and Code of Federal Regulation (CFR) Title 48 Section 3.908 Whistleblower Protection. NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA 82 EXHIBIT C TERMS AND CONDITIONS C.1.1 Qualifications. The Contractor represents that it is competent to perform the services specified in this Contract.All of the services required hereunder will be performed by the Contractor or under its supervision, and all personnel engaged in the work shall be fully qualified and shall beauthorized under state and local law to perform such services. C.1.2 Interest of Contractor. The Contractor cove.nants that it presently has no interest and shall not acquire any interest, direct or indirect, which would conflict in any manner or degree with the performance of servicesrequired to be performed under this Contract. No person hiving any such interest shall beemployed or participate in any decision relative to this contract. C.1.3 Prohibition Against Employing lllegal Aliens. C.1.3'i Prohibition Against Employing lllegal Aliens: Colorado Requirement. Contractor shall not knowingly employ or contract with an illegal alien to perform work under theContract. Contractor shall not enter into a contract with a subiontractor that fails to certify to theContractor that the subcontractor shall nottnowingly employ or contract with an illegal aiien toperform work under the Contract. Exhibit F, the "E-Verify Federal Contractor nute fmp6yment Eligibility Verification", must be signed and returned with the Contract, which is attached heretoand incorporated herein by reference. a' Contractor will participate in either the E-verify program or the Department of laf_o1and Employment ("D-epartment") program, as defined-in C.n.S. SS g-1Lsllol (3.3) and B-17 -5-101 (3.7), now in effect and as amended from time to time, in oiOer to confirm theemployment eligibility of a1l employees who are newly hired for employment to perform workunder the public contract for services, as defined by C. R.S. S B-1 7.5-i01 (6), now in effect andas amended from time to time. lf Contractor participates in the Department'program, Contractorshall deliver to NWCCOG a written, notarized affirmation, affirming that Contraltor hasexamined the legal work status of such employees, and shall comply with all other requirements of the Department program. b. Contractor is prohibited from using the E-verify program or the Departmentprogram procedures to undertake pre-employment screening of jo-b applicants while theContract is being performed. lf Contractorwiil be participatin-g inine fiepartment program, Contractor will provide to NWCCOG a copy of Contractor's e-xecuted Notice of eirticipation inthe Department Program form. c. lf Contractor obtains actual knowledge that a subcontractor performing workunder the Contract for services knowingly employs or contracts with an illegal alien, Contractorshall: _ (1) notify the subcontractor and NWCCOG within three days that theContractor has actual knowledge that the subcontractor is employing or contracting with anillegalalien; and NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA cl (2) terminate the subcontract with the subcontractor if within three days ofreceiving the notice required pursuant to this paragraph the subcontractor does not stop employing or contracting with the illegal alien; except that the Contractor shall not terminate the contract with the subcontractor if during such three days the subcontractor provides information to establish that the subcontractor has not knowingly employed or contracted with an illegal alien. d. Contractor shall comply with any reasonable request by the Department made in the course of an investigation that the Department is undertaking pursuant to ihe authority established in C.R.S. S 8-17.5-102(5). e. lf Contractor violates a provision of the Contract required pursuant to C.R.S. $ B- 17.5-102, NWCCOG may terminate the contract for breach of contract. li the contract is so terminated, the Contractor shall be liable for actual and consequential damages to NWCCOG. t' This Section C.1.3 shall not apply to the following types of contracts: (1) intergovernmentalagreements; (2) agreements for information technology services or products and services; (3) agreements relating to the offer, issuance, or sale of securities; (4) agreements for investment advisory services or fund management Services; any grant, award, or contract funded by any federal or private entity for any research or sponsored project activity of an institution of higher education or an affiliate of an institution of higher education thai is funded from moneys that are restricted by the entity under the grant, award, or contract, pursuant to C.R.S. S B-17.5-101(6Xb). C.1'3'ii Prohibition Against Employing lllegal Aliens: Federal Requirement. lf the Contract includes an award of Federal funds of more than $3,000, Contractor must also comply with the E-Verify Federal Contractor Rule, set forth in Exhibit F, which requires the Contactor to use the E-Verify program to verify the employment eligibility of all employees assigned to the Contract and all new hires. C.1.4 Sub-qrant or Subcontract. C.'l '4.a None of the work or services covered by this Contract shall be sub-granted or subcontracted to any other party without the prior written approval of NWCCOG. Fiilure to obtain NWCCOG's prior approval of any additional sub-grantors or subcontractors shall result inthe disallowance of reimbursements for any services prwided by sub-grantor or subcontractor not previously approved. C'1'4.b Prior to submitting the sub-grant(s)/subcontractor(s) for approval by NWCCOG, Contractor shall verify that sub-grantee and subcontractor is not piesentiy debaned, suspended,proposed for debarment, declared ineligible, or voluntarily exclud.ed from participation by any federal department or agency pursuant to 2 CFR part 37-6.Q Contractor shall submit verification of non-exclusion or non-disqualification upon request C'1'4-c Any approval by NWGCOG of a sub-grantee or subcontractor shall be effective only through the current contract fiscal year and subject to the continuing requirement of non- (5) NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA C2 exclusion or non-disqualification pursuant to 2 CFR Part 376. lt shall be Contractor's responsibility to submit verification of such non-exclusion or non-disqualification upon request. C'1'4.d Contractor is responsible for compliance with all provisions of the Contract by each sub-grantee/subcontractor engaged by Contractor in connection with the work to be performed under this Contract. Contractor warrants and agrees that all sub-grants/subcontracts resulting from its performance under the terms and conditions of the Contract shall include a provision that the sub-grantee/subcontractor shall abide by the terms and conditions of the Contract. Also, Contractor warrants and agrees that all sub-grantsisubcontracts shall include a provision that the sub-grantee/subcontractor shall indemnify and hold harmless the State. The sub-grantee/subcontractor must be certified to work on any equipment for which their services are obtained. C.1.5 Confidentiality. Contractor shall protect the confidentiality of all consumers in accordance with the HIpAA Privacy Rule at 45 CFR Parts 160 and 164, now in effect. Federal law and regulations governing the privacy of certain health information requires a "Business Assoliate Contract" between the NWCCOG and the Contractor. Contractor shall advise its employees, volunteers or agents that they are subject to these confidentiality requirements and shall provide its employees, volunteers or agents, with a copy or written explanation of these confidentiality requirements before access to confidential data is permitted. The HIPPA Business Associate Agent's Addendum, attached to the Contract as Exhibit E, is incorporated herein. C.1.6 Discrimination. The Contractor shall: a. Not discriminate against any person on the basis of race, color, national origin, age, sex, religion and handicap, including Acquired lmmune Deficiency Syndrome (A|-DS) or AIDS related conditions. b. Not exclude from participation in, or deny benefits to any qualified individual with a disability, by reason of such disability. c. Agree to take positive steps to employ and advance in employment qualified handicapped persons and to comply with Department of Healih and Human Services Regulations (45 CFR Part 84). d. Allow any person who thinks he/she has been discriminated against as related to the performance of this contract has the right to assert a clairn, Coiorado Civil Rights Division, C.R.S. 524-34-902, et seq. e. Comply with all applicable Federal laws, regulations, and orders regarding "Equal Employment Opportunity", as from time to time amended, as supplemented in the Department of Labor Regulations (41 CFR part g4). C.1.7 Lobbying Restrictions. Contractor shall not use funds made available under the OAA/SFSS for lobbying activities, as described at Section 24-6-30'1, C.R.S., including, but not limited to activities inte.-nOed to influence decision or activity by non-judicial Federal, State or local officials or body. C.1.8 Records. NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA c3 C.1.B.a The Contractor agrees to retain all records pertinent to this Contract for a period of three (3) years after final payment hereunder. In the event that activities or costs are questioned by audit, records shall be retained until all questioned items are resolved. Contractor shall maintain confidentiality of information relating to specific consumers by ensuring that such information is gathered only with the informed consent of the consumer, such information is used only for the purposes gathered, adequate security of records is maintained to prevent unauthorized use, access to consumer records and identifiable information is limited only to program staff, and consumer files are kept under lock and key after use. Contractor shail maintain the confidentiality of protected health information as required by law, including the consumer's individually identifiable health information. 9.1.8 I Accounting Records. Records which identify adequately the source and application of funds for Contract activities shall be maintained for the period provided in C.1.8a above and shall comply with the requirements of the Older Americans Act, Colorado Revised Statutes, Rule Manual Volume 10 and the SUA Policy and Procedure Manual, as from time to time amended. C.1'8.c Additional Records Required. Contractors shalldevelop and maintain the records required by applicable laws and regulations including but not limited to the Section of the SUA Policy and Procedure Manual and including the following records: personnel records for each employee to include documentation of training, documentation of supervision, and documentation of current licensure if applicable; a Targeting Plan; Emergency Response plan; confidentiality procedures; procedures for handling and reporting of criticll inlidents, including accidents, suspicion of abuse, neglect or exploitation, and criminal activity; a log of all complaints and critical incidents; records for each older adult served; and traveidocumentation policies and procedures. These shall be maintained by the Contractor and made available to NWCCOG, SUA and/or their authorized representatives upon request. (1) Targeting Plan. The Older Americans Act (OAA) requires that program services target vulnerable populations that are traditionally underserved due to isolation, ethnic, cultural, language barriers, socioeconomic or other factors. Contractor is required to identify specific target populations within the Contract's seryice area(s), with particular attention to older individuals identified in Section 306, Area Plans (a)(4)(i) of the OAA, and provide a plan to reach these high priority populations. (2) Emergency Response Plan. Contractor will communicate, coordinate, and plan for cooperation with county emergency response managers/coordinators and their staff. ier State Unit on Aging Policy Directive the State may require the Contractor to develop and implement an Emergency Response Plan relative to coordination with their respective county representative as stated above. All other contracted service providers may develop and implement such plans as appropriate for their agency and community. C.2 FISCALMANAGEMENTREQUIREMENTS C.2.1 OAA/SFSS Payor of Last Resort. Contractor will not use OAA/SFSS funds to duplicate services that may be funded through Medicaid, Medicare, Title XX or other available federal, state, or local iources. C.2.2 Financial Management. NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA c4 C.2'2.a Contractor agrees to adhere to generally accepted accounting principles andprocedures, utilize adequate internal controls, and maintain necessary iource documentation for all revenues received and costs incurred. C'2.2.b Contractor shall administer the program with the provisions of the Older Americans Act, Colorado Revised Statutes, Rule Manual Volume 10 and the SUA policy and procedure Manual, as from time to time amended, including but not limited to complianie with costprinciples set forth in conformance with OMB Circular A-1}2"Grants and Cooperative Agreements with State and Local Governments" or OMB A-110 "Uniform Administrative Requirements for Grants and Agreements with institutions of Higher Education, Hospitals orOllgt Non-profit Organizations", and Federal Acquisition Regulations at 48 C.F.R . par131.2, whichever may apply. C.2.3 ContractorAudits. C'2'3.a The Contractor shall ensure that an annual independent audit is conducted of the Contractor's financial records in accordance with the requirements of OMB Circular A-133. The Contracior shall, upon request, make a copy of the audit available for review by NWCCOG and/or SUA. C.2.3'b Should an audit or other financial review disallow any reimbursed costs, the disallowed funds shall be returned to NWCCOG or, in NWCCOG's discretion and to the extentpermitted by Federal and State law and regulations, offset against current or future payments to Contractor. Failure to fulfill these audit obligations is a breach of this Contract and will subject Contractor to all remedies available herein and at law, including all funds being due and piyable back to NWCCOG. C.2.3.c NWCCOG, HHS, State and FederalAudits and Inspections. During the Contract period, the retention period, and as long thereafter as the records are maintained, at any time during normal business hours, Confractor shall make available to NWCCOG, HHS, the State and the Comptroller General of the United States, or their authorized representatives, any Pgokg, d_ocuments, papers or other records of the Contractor with respectto all matters covered by the Contract in order to make audit, examination, excerpts, and transcripts. Contractor acknowledges that disclosure of protected health information'to NWCCOG, HHS, the State and the Comptroller Generai of the United States and their authorized representatives is permitted pursuant to Federal law. Failure to make records available for inspection within seventy-two (72) hours of notice shall be deemed a violation ofthe Contract. C.3 PROGRAM REQUIREMENTS C.3.1 EligibilityAssessments. C.3'1.a The Contractor will conduct an assessment of individual eligibility prior to the delivery of any registered services, as defined in 45 CFR 1321.3, using the stinOaiOized assessment form provided by NWCCOG, and re-assessments will be conducted every six months thereafter as applicable for any registered service continuing after six months. The bontractor may not alter the standardized assessment form providedby NWCCOG; however, the Contractor may NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA c5 attach as separate sheet(s) an addendum to the assessment to meet any additional program/service specific needs. Any addendum must be approved in advance by NWCCOG. C.3.1.b Eligibility for services provided under this Contract shall be only that the individual receiving service is age 60 or above unless other eligibility requirements exists within Rule Manual Volume 10 or SUA Policy and Procedure for the contracted service. C.3.1.c Consumer Information Assessments (for Registered Services). Contractor will adhere to and follow the SUA Policy and Procedure Manual and Volume 10 for "Consumer lnformation Assessments" for Purpose, Background, Policy, Assessment Instrument, and Instructions for the requirements for completing and maintaining consumer information assessments. C.3.2 Tarqetinq. The OAA requires that program services target vulnerable populations that are traditionally underserved due to isolation, ethnic, cultural, language barriers, socioeconomic or other factors), with particular attention to older individuals identified in Section 306, Area Plans (aX+Xi) of the OAA. C.3.3 Backqround Check: Driver's License. C.3.3.a Employees, volunteers or contractors responsible for transporting consumers shall have a valid Colorado driveds license, and shall not have any alcohol related offenses in the past three years, or two or more convictions or chargeable accidents within the past two (2) years. C.3.3.b Contractor shall ensure that prior to delivery of services, a records check through the Colorado Bureau of Investigations (CBl) or another background check system that provides information at the same level of detail or higher than the CBI records check, shall be conducted for all employees, volunteers, independent contractors, and subcontractors of Contractor who is directly providing one or more of the following services: personal care, homemaker, adult day, transportation, case management, chore or home modifications that are provided through a contracted agency, home delivered meals, materialaid services (provided within a consume/s home), one-to-one legal, one-to-one counseling, or respite care. Contractor shall ensure that appropriate follow-up of the background check is completed according to the SUA Policy and Procedure Manual Subsection, and shall ensure that its employees, volunteers, independent contractors, and contractors are in compliance with the restrictions of Subsection. C.3.4 Contractor Training. Contractor shall attend trainings and/or meetings through NWCCOG to provide training and technical assistance, contract management of this Contract, approved data entry methods, and data collection and reporting on services contained within the Area Plan and Funding Request. C.3.5 Monitorinq and Reportino Proqram Performance. C.3.5.a The activities of Contractor in providing the services set forth under this Contract shall be monitored by NWCCOG in accordance with the applicable provisions of 45 CFR Par174 and 45 CFR Parl92, other applicable Federal regulations, and this Contract. NWCCOG will monitor all activities of Contractor supported by this Contract to assure that the services being performed are consistent with the Contract and applicable Federal regulations. Contractor NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA c6 acknowledges that disclosure of protected health information to NWCCOG is permitted pursuant to Federallaw. C.3.5.b Monthly Data Entry. The FederalAdministration on Communi$ Living (ACL) requires certain OAA/SFSS data to be reported in the NationalAging Program Information System (NAPIS) or in the National Ombudsman Reporting System (NORS). To assist in the data collection for NAPIS/NORS, the State requires all Contractors to report services provided in a State software system as designated and assisted by the State from time to time. Currently the software utilized is Senior Assistance Management System (SAMS). ACL utilizes the data system to collect data, track, assess, and measure program performance. In addition, ACL uses data to assess aging program progress in service delivery, populations served, and quality of grantee efforts. Contractor must complete training on SAMS for all employees who will be performing the data entry service. Training is available each year and is mandatory for anyone who has not previously attended or as deemed appropriate by NWCCOG. C.3.5.c PerformanceReports. Contractor shall submit to the NWCCOG a monthly client and service delivery report, due on or before the 15th (fifteenth) day of the following month, throughout the period of the Contract. The performance report shall be in a form or using systems prescribed by the NWCCOG, containing information required by the NWCCOG, and in accordance with guidelines issued by the State of Colorado and ACL. Failure to report data correctly and timely is a violation of this Contract and NWCCOG may exercise any remedies available under the Contract or at law, including withholding payments. C.3.5.d FinancialReports. Contractor shall submit to the NWCCOG a monthly fiscal report, due on or before the fifteenth (15) day of the following month, throughout the period of the Contract. The fiscal report shall be in a form or using systems prescribed by the NWCCOG, containing information required by the NWCCOG and in accordance with guidelines issued by the State of Colorado and ACL. Failure to report fiscal data correctly and timely is a violation of this Contract and NWCCOG may exercise any remedies available und the Contract or al law, including withholding payments. C.3.6 State and NWCCOG Contract Performance Focus.a. As set forth and defined herein, the "Contract Performance Focus" is a performance-based analysis strategy the State, NWCCOG, and Contractor shall use in association with the Contractor's performance under the Contract that allows the parties to better focus on and improve performance measures to obtain maximum benefits from the work the Contractor performs under the Contract. By identifying areas of focus, the parties shall determine what aspects of the Contractor's performance are working and what aspects of said performance need improvement. By measuring the impact of dayto-day work of the Contractor, the parties will be able to make more informed collaborative decisions to align the work of the Contractor to affect more positive performance outcomes and change for the purposes served through the Contract. b. Performance Measures Reports shall reflect relevant report data for the performance measures identified hereunder to be tracked on an ongoing basis through the Contract Performance Focus process. Performance measures will continue to evolve to meet the objective of measuring key performance outcome indicators for the work of the Contractor. NWCCOG-Alpine Area Agenry on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA c7 c. The Contractor shall collect data for each performance measure and report this data to the State on dates established by the State. The Contractor shall report data on forms developed by the State. ln the absence of such forms, the Contractor may report on performance data using tools and documents of their choosing. d. Changes and Additions to Performance Measures. (1) The State may add a new performance measure or change any of the performance measures described in the contract between NWCCOG and the State. lf the State adds or changes a performance measure, NWCCOG will provide to Contractor the State's written notice prior to the effective date of the new/revised measure. lf exercised the new/revised measure shall be incorporated into the Option Letter issued by the NWCCOG. C.3.7 ConsumerComplainVAppeal Process. The Contractor shall develop a procedure to assure that applicants to, or clients of, their services are advised in writing of their right to complain about services or the denial of services, to appeal decisions made about the complaint, and that those complaints and appeals, are processed and tracked in compliance with SUA Policy and Procedure and as directed by NWCCOG. ComplainUappeals documentation may be kept in hard copy or electronically, but must be printable. Contractor shall retain complainVappeal documentation, and shall retain records in accordance with Section C.1.8 herein. C.3.8 Voluntary Contributions and Non-eligible Recipient Fees. Contractor shall (i) provide each recipient with an opportunity to voluntarily contribute to the cost of the service; (ii) clearly inform each recipient that there is no obligation to contribute and that the contribution is purely voluntary; (iii) protect the privacy and confidentiality of each recipient with respect to the recipient's contribution or lack of contribution; (iv) establish appropriate accounting procedures to safeguard and account for all contributions; (v) use all collected contributions to expand or enhance the service for which the contributions were given; and (vi) identify the income as program income and expend it in accordance with C.3.9.a below. Contractor shall establish minimum standards and procedures for the responsible collection of, handling, and safeguarding of consumer contributions and non-eligible recipient fees in compliance with SUA Policy and Procedure Manual. C.3.9 lncome. C.3.9.a Program income, including participant contributions, earned by the Contractor from activities which are supported by the Contract shall be added to funds committed to the project or program and used for allowable costs of services under the Contract to further the objectives of the Contract as provided under 45 CFR 74.24(b)('l). C.3.9.b Program income must be fully expended within the reporting month it was received and cannot be carried over for any period of time. C.3.10 Income Accounting Records. NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA c8 Program income must be accounted for according to the additional costs alternative specified in Section C.1.8 above and pursuant to 45 CFR, Section74.24. C.3.11 Waiting Lists. C.3.11.a Contractor shall establish and maintain waiting lists when services are available but cannot be provided to all eligible consumers. In such circumstances, Contractor shall place eligible consumers on a waiting list. Waiting list procedures must be equitable to all eligible consumers. Contractor shall give priority to consumers targeted by the Older Americans and Older Coloradans Act, with due consideration given to the time kept on a wait list. Persons shall be removed from the waiting list in accordance with SUA Policy and Procedure Manual. Contractor will develop a waiting list procedure in compliance with the policies set forth in the Policy and Procedure Manual, regardless of whether or not there are consumers waiting for service. C.3.11.b Contractor shall maintain waiting lists, and shall make the waiting list and the procedures for the waiting list readily available for review by NWCCOG and/or the State Unit on Aging. Waiting list documentation may be kept in hard copy or electronically, but must be printable. Contractor shall retain waiting list documentation, and shall not destroy any such records until notified by NWCCOG. C.3.12 Outreach. Contractor will ensure consumer access and awareness of services they provide and of the Alpine Area Agency on Aging through outreach and marketing which may include a website, social media, or other means. C.3.13 Policy Changes. From time to time during the term of this Contract, NWCCOG and/or the State Unit on Aging may adopt policies and procedures that relate to services provided under this Contract. Upon notice of such adopted policies or procedures, Contractor shall incorporate any such policies and procedures into their practices and comply with the provisions thereof. C.4 OTHER REQUIREMENTS C.4.1 Acknowledging Funding Support. C.4.1.a Contractorwillinclude statements identifying the Northwest Colorado Councilof Governments as a funder for all services provided on all program outreach materials. C.4.1.b Contractor must include on all publications and printed materials resulting from this Contract, other than documents exclusively for internal use by Contractor, a statement of acknowledgement of the funding support received under the Older Americans Act and/or Older Coloradans Act. C.4.2 Assignability. The Contractor shall not assign any interest in this Contract, and shall not transfer any interest in the same (whether by assignment or novation), without the prior written consent of NWCOG thereto; provided, however, that claims for money due or to become due to the Contractor from NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA c9 NWCCOG under this Contract may be assigned to a bank or other financial institution without such approval. Notice of any such assignment or transfer shall be furnished to NWCCOG. C.4.3 On-Site Assessment. The Contractor will adhere to and follow the SUA Policy and Procedure Manual for Purpose, Background, Policy and Criteria of service on-site assessments and requirements of the NWCCOG and State. C.4.4 Publication, Reproduction and Use of Material. Material produced in whole or in part under this Contract may not be subject to copyright taws. C.4.5. Volunteers. lf the Contractor utilizes volunteers to provide services, the Contracting organization shall document how volunteers will be utilized in the program(s) including, but ncit limited to, the use of time sheets and job descriptions. NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA c10 EXHIBIT D INDEMNIFICATION & INSURANCE REQU IREMENTS D.1 Indemnification. To the extent allowable by law, the Contractor agrees to indemnify and hold harmless the State of Colorado, NWCCOG, their officers, employees, and insurers, from and against all liability, claims, and demands, on account of injury, loss, or damage, including without limitation claims arising from bodily injury, personal injury, sickness, disease, death, property loss or damage, or any other loss of any kind whatsoever, which arise out of or are in any manner connected with this Contract, if such injury, loss, or damage is caused in whole or in part by, or is claimed to be caused in whole or in part by, the act, omission, error, professional error, mistake, negligence, or other fault of the Contractor, any subcontractor or subcontractor of the Contractor, or any officer, employee, representative, or agent of the Contractor or of any subcontractor or subcontractor of the Contractor, or which arise out of any workers' compensation claim of any employee of the Contractor or of any employee of any subcontractor or subcontractor of the Contractor. The Contractor agrees to investigate, handle, respond to, and to provide defense for and defend against, any such liability, claims, or demands at the sole expense of the Contractor. The Contractor also agrees to bear all other costs and expenses related thereto, including court costs and attorney fees, whether or not any such liability, claims, or demands alleged are groundless, false, or fraudulent. No term or condition of this Gontract shall be construed or interpreted as a waiver, express or implied, of any of the immunities, rights, benefits, protection, or other provisions for the parties, of the Colorado GovernmentallmmunityAct, C.R.S. S 24-10-101 ef seg. orthe FederalTort claims Act, 28 u.s.c. S 2671 ef seg. as applicable, as now or hereafter amended. The Contractor, by execution of this Contract containing this indemnification clause, is relying upon and does not waive the operation of any law concerning the Contractor's ability to indemnify. D.2. Insurance. D.2.1 The Contractor agrees to procure and maintain, at its own cost, a policy or policies of insurance sufficient to insure against all liability, claims, demands, and other obligations assumed by the Contractor pursuant to Section D.1 of this Exhibit D. Such insurance shall be in addition to any other insurance requirements imposed by this agreement or by law. The Contractor shall not be relieved of any liability, claims, demands, or other obligations assumed pursuant to Section D.1 of this Exhibit D by reason of its failure to procure or maintain insurance, or by reason of its failure to procure or maintain insurance in sufficient amounts, durations, or types. D.2.2 Contractor shall procure and maintain, and shall cause each subcontractor hired to perform services under this Contract pursuant to its' obligations herein to procure and maintain, the minimum insurance coverages listed below. Such coverages shall be procured and maintained with forms and insureis acceptable to NWCCOG. All coverages shall be continuously maintained through the term of this contract to cover all liability, claims, demands, and other obligations assumed by the Contractor pursuant to Section D.1 of this Exhibit D. NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA D1 ln the case of any claims-made policy, the Contractor will keep the coverage in place for three (3) years after the end of the contract period. Evidence of qualified self-insured status may be substituted for the insurance requirements listed below. a. Workers'Compensationlnsurance. Workers' Compensation insurance to cover obligations imposed by applicable laws for any employee engaged in the performance of work under this agreement, and Employers' Liability insurance with minimum limits of ONE HUNDRED THOUSAND DOLLARS ($100,000) each accident, FIVE HUNDRED THOUSAND DOLLARS ($500,000) disease policy limit, and ONE HUNDRED THOUSAND DOLLARS ($100,000) disease - each employee. Provide a waiver of subrogation in favor of NWCCOG. b. General Liability Insurance. General Liability insurance with minimum combined single limits of ONE MILLION DOLLARS ($1,000,000) each occurrence and ONE MILL|ON DOLLARS ($1,000,000) aggregate. The policy shall be applicable to all premises and operations. The policy shall include coverage for bodily injury, broad form property damage (including completed operations), personal and advertising injury (including coverage for contractual and employee acts), blanket contractual, products, and completed operations, and shall provide for defense of sexual abuse and molestation claims for innocent insureds. The policy shall contain a severability of interests provision. c. ComprehensiveAutomobileLiabiliglnsurance. Comprehensive Automobile Liability insurance with minimum combined single limits for bodily injury and property damage of not less than oNE MlLLloN DOLLARS ($1,000,000) each occurrence and ONE MILLION DOLLARS ($1,0OO,OOO) aggregate with respect to each of Contractor's owned, hired or non-owned vehicles assigned to or used in performance of the services. d. Security and Privacy Liability or Cyber Risk Insurance. Security and Privacy Liability or Cyber Risk insurance to cover loss of Protected Health Information ("PHl') data and claims based upon alleged violations of privacy rights through improper use or disclosure of PHI with minimum annual limits as follows: ' Contractors with 10 or less clients and revenues of $250,000 or less shall maintain limits on Privacy Liability Insurance of not less than $50,000.. Contractors with 25 or less clients and revenues of 9500,000 or less shall maintain limits on Privacy Liability Insurance of not less than $100,000.. Contractors with more than 25 clients and revenues of more than 9500,000 shall maintain limits on Privacy Liability Insurance of not less than $1,000,000. e. Professional Liability Insurance. Professional Liability insurance in the amount of ONE MILLION DOLLARS ($1,000,000) each occurrence for coverage to defend against allegations as well as damages resulting from failure to perform on the part of, financial loss caused by, and enor or omission in the service or product of the policy holder. D,3 _ EY"ry policy required above shall be primary insurance, and any insurance carried by NWCCOG, its officers, or its employees, shall be excess and not contributory insurance to that NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA D2 provided by Contractor. No additional insured endorsement to the policy required by paragraph (1) above shall contain any exclusion for bodily injury or property damage arising from completed operations. The Contractor shall be solely responsible for any deductible losses under any policy required above. D.4 A certificate of insurance evidencing coverage and naming NWCCOG, its officers and its employees as additional insureds on the general liability and automobile liability policies shall be completed by the Contracto/s insurance agent as evidence that policies providing the required coverages, conditions, and minimum limits are in fullforce and effect, and shall be reviewed and approved by NWCCOG prior to commencement of the agreement. In the case of qualified self- insurance status, NWCCOG may require satisfactory evidence of sufficient funding for such purposes. The certificate shall identify this Contract and shall provide that coverages afforded under the policies shall not be cancelled, terminated or materially changed until at least 30 days prior written notice has been given to NWCCOG. tr The completed certificate and/or evidence of qualified self-insured status must be sent with the signed Contract to: Northwest Colorado Council of Governments Attention: Alpine Area Agency on Aging PO Box 23O8:249 Warren Avenue Silverthorne, CO 80498-2308 D.5 Failure on the part of the Contractor to procure or maintain policies providing the required coverages, conditions, and minimum limits shallconstitute a material breach of this agreement upon which NWCCOG may immediately terminate this agreement, or at its discretion, NWCCOG may procure or renew any such policy or any extended reporting period thereto and may pay any and all premiums in connection therewith, and all monies so paid by NWCCOG shall be repaid by Contractor to NWCCOG upon demand, or NWCCOG may offset the cost of the premiums against any monies due to Contractor from NWCCOG . D.6 NWCCOG reserves the right to request and receive a certified copy of any policy and any endorsement thereto. D.7 The parties hereto understand and agree that NWCCOG is relying on, and does not waive or intend to waive by any provision of this agreement, the monetary limitations (presently $150,000 per person and $600,000 per occurrence) or any other rights, immunities, and protections provided by the Colorado Governmental lmmunity Act,24-10-101 et. seq., C.R.S., as from time to time amended, or otherwise avaihble to NWCCOG, its officers, or its employees. D.8 Unless othenruise provided herein, the Contractor, if a governmental entity, may elect to self-insure for any of the coverage areas required by subsections D.2.2.athru D.2.2.c. In such case, the Contractor shall maintain a claims fund that is available solely to pay claims against the Contractor that are proven or otherwise settled by the Contractor in its sole discretion. Such claims fund is intended for and available for only those purposes and is not available or allocated to fund a commitment or obligation, if any, or to defend or indemnify any party. Payments out of such funds may require approval by the Contracto/s governing body. lt is understood and agreed that a commitment by the Contractor to self-insure by the creation of said claims fund does not commit the Contractor to othenruise appropriate funds to fund self- insurance for this Contract or for any other commitment of the Contractor, and it is further understood and agreed that the Contractor has not appropriated funds for such purpose. In NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA case of such election to self-insure, the Contractor shall itself provide NWCOG with written confirmation of the Contractor's self-insured status and the existence of said claims fund. NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA D4 EXHIBIT E HIPAA BUSINESS ASSOCIATE AGENT'S ADDENDUM This Business Associate's Agent Addendum ('Addendum)" is part of the Contract between Northwest Colorado Council of Governments Alpine Area Agency on Aging and Contractor. For purposes of this Addendum, the State of Colorado is referred to as "Covered Entity" or "CE", the Northwest Colorado Council of Governments Alpine Area Agency on Aging, as a Business Associate to the CE, is referred to as "Associate", and Contractor is referred to as "Associate's Agent". Unless the context clearly requires a distinction between the Purchases of Services Contract document and this Addendum, all references herein to "the Contract" include this Addendum. RECITALSA. CE wishes to disclose certain information to Associate and Associate's Agent pursuant to the terms of the Contract, some of which may constitute Protected Health Information ("PHl') (defined below). B. CE, Associate and Associate's Agent intend to protect the privacy and provide for the security of PHI disclosed to Associate's Agent pursuant to the Contract in compliance with the Health Insurance Portability and Accountability Act of 1996,42 U.S.C. S 1320d - 1320d-8 ("HlPA4'; and its implementing regulations promulgated by U.S. Department of Health and Human Services, 45 C.F.R. Parts 160 and 164 (the "Privacy Rule") and other applicable laws, as amended. C. The Associate's contract with the CE requires the Associate to enter into an agreement containing specific requirements with Associate's Agent prior to the disclosure of PHl, as set forth in, but not limited to, Title 45, Sections 160.103, 164.502(e) and 164.504(e) of the Code of Federal Regulations ('C.F.R.') and contained in this Addendum. The parties agree as follows: E.1. DEFINITIONS a. Except as otherwise defined herein, capitalized terms in this Addendum shall have the definitions set forth in the HIPAA Privacy Rule at 45 C.F.R. Parts 160 and 164, now in effect and as amended from time to time ("Privacy Rule") . ln the event of any conflict between the mandatory provisions of the Privacy Rule and the provisions of the Contract, the Privacy Rule shall control. Where the provisions of the Contract differ from those mandated by the Privacy Rule, but are nonetheless permitted by the Privacy Rule, the provisions of the Contract shall control. b. "Protected Health Information" or "PHl" means any information, whether oral or recorded in any form or medium: (i) that relates to the past, present or future physical or mental condition of an individual; the provision of health care to an individual; or the past, present or future payment for the provision of health care to an individual; and (ii) that identifies the individual or with respect to which there is a reasonable basis to believe the information can be used to identify the individual, and shall have the meaning given to such term under the Privacy Rule, including, but not limited to,45 C.F.R. Section 164.501.c. "Protected Information" shall mean PHI provided by CE to Associate or Associate's Agent or created or received by Associate or Associate's Agent on CE's behalf. To the extent Associate NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA E1 and Associate's Agent is a covered entity under HIPAA and creates or obtains its own PHI for treatment, payment, and health care operations, Protected Information under the Contract does not include any PHI created or obtained by Associate or Associate's Agent as a covered entity and Associate and Associate's Agent shall follow its own policies and procedures for accounting, access, and amendment of Associate's or Associate's Agent's PHl. E.2. OBLIGATIONS OF ASSOCIATE'S AGENT a. Permitted Uses. Associate's Agent shall not use Protected lnformation except fOr the purpose of performing Associate's Agent's obligations under the Contract and as permitted under this Addendum. Further, Associate's Agent shall not use Protected Information in any manner that would constitute a violation of the Privacy Rule if so used by Associate's Agent, except that Associate's Agent may use Protected Information: (i) for the proper management and administration of Associate's Agent; (ii) to carry out the legal responsibilities of Associate's Agent; or (iii) for Data Aggregation purposes for the Health Care Operations of CE. b. PermittedDisclosures. Associate's Agent shall not disclose Protected Information in any manner that would constitute a violation of the Privacy Rule if disclosed by CE, except that Associate's Agent may disclose Protected Information: (i) in a manner permitted pursuant to the Contract; (ii) for the proper management and administration of Associate's Agent; (iii) as required by law; (iv) for Data Aggregation purposes for the Health Care Operations of CE; or (v) to report violations of law to appropriate federal or state authorities, consistent with 45 C.F.R. Section 164.5020X1). To the extent that Associate's Agent discloses Protected Information to a third party, Associate's Agent must obtain, prior to making any such disclosure: (i) reasonable assurances from such third party that such Protected Information will be held confidential as provided pursuant to this Addendum and only disclosed as required by law or for the purposes for which it was disclosed to such third party; and (ii) an agreement from such third party to notify Associate's Agent within two business days of any breaches of confidentiality of the Protected Information, to the extent it has obtained knowledge of such breach.c. Appropriate Safequards. Associate's Agent shall implement appropriate safeguards as are necessary to prevent the use or disclosure of Protected Information other than as permitted by the Contract. Associate's Agent shall maintain a comprehensive written information privacy and security program that includes administrative, technical and physical safeguards appropriate to the size and complexity of the Associate's Agent's operations and the nature and scope of its activities.d. Reportinq of lmproper Use or Disclosure. Associate's Agent shall report to Associate in writing any use or disclosure of Protected Information other than as provided for by the Contract within five (5) business days of becoming aware of such use or disclosure. e. Third-Partv Beneficiaries. The CE and Associate are identified as third party beneficiaries with rights of enforcement and indemnification from such subcontractors or agents in the event of any violation of such Associate's Agent's agreement. Associate shall implement and maintain sanctions against Associate's Agent that violates such restrictions and conditions and shall mitigate the effects of any such violation. NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA E2 f. NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 g. Access to Protected Information. Associate's Agent shall make Protected Information maintained by Associate's Agent in Designated Record Sets available to CE for inspection and copying within ten (10) business days of a request by CE to enable CE to fulfill its obligations to permit individual access to PHI under the Privacy Rule, including, but not limited to, 45 C.F.R. Section 164.524. Amendment of PHl. Within ten business (10) days of receipt of a request from CE for an amendment of Protected Information or a record about an individual contained in a Designated Record Set, Associate's Agent shall make such Protected Information available to CE for amendment and incorporate any such amendment to enable CE to fulfill its obligations with respect to requests by individuals to amend their PHI under the Privacy Rule, including, but not limited to, 45 C.F.R. Section 164.526. lf any individual requests an amendment of Protected Information directly from Associate's Agent, Associate's Agent must notify cE in writing within five (5) business days of receipt of the request. Any denial of amendment of Protected Information maintained by Associate's Agent shall be the responsibility of cE. Accountino Riqhts. Within ten (10) business days of notice by CE of a request for an accounting of disclosures of Protected Information, Associate's Agent shall make available to CE the information required to provide an accounting of disclosures to enable CE to fulfill its obligations underthe Privacy Rule, including, but not limited to,45 C.F.R. Section 164.528. As set forth in, and as limited by, 45 c.F.R. Section 104.s28, Associate's Agent shall not provide an accounting to CE of disclosures:(i) to carry out treatment, payment or health care operations, as set forth in 45 C.F.R. Section 164.506;(ii) to individuals of Protected Information about them as set forth in 45 C.F.R. Section 164.502; (iii) pursuant to an authorization as provided in 45 C.F.R. Section 164.508; (iv) to persons involved in the individual's care or other notification purposes as set forth in 45 C.F.R. Section 164.510;(v) for national security or intelligence purposes as set forth in 45 C.F.R. Section 164.512(k)(2); (vi) to correctional institutions or law enforcement officials as set forth in 45 C.F.R. Section 164.512(k)(5); (vii) incident to a use or disclosure otherwise permitted by the Privacy Rule; (viii) as part of a limited data set under 45 C.F.R. Section 164.514(e); or(ix) disclosures prior to April 14, 2003. Associate's Agent agrees to implement a process that allows for an accounting to be collected and maintained by Associate's Agent for at least six (6) years prior to the request, but not before the compliance date of the Privacy Rule. At a minimum, such information shall include:(i) the date of disclosure;(ii) the name of the entity or person who received Protected Information and, if known, the address of the entity or person; (iii) a brief description of Protected Information disclosed; and(iv) a brief statement of purpose of the disclosure that reasonably informs the individual of the basis for the disclosure, or a copy of the individual's authorization, or a copy of the written request for disclosure. h. Purchase of Services Contract OAA/OCA E3 In the event that the request for an accounting is delivered directly to Associate's Agent, Associate's Agent shall within five (5) business days of the receipt of the request fonruard it to CE in writing. lt shall be CE's responsibility to prepare and deliver any such accounting requested. Associate's Agent shall not disclose any Protected Information except as set forth in Section 2(b) of this Addendum.i. GovernmentalAccess to Records. Associate's Agent shall make its internal practices, books and records relating to the use and disclosure of Protected Information available to the Secretary of the U.S. Department of Health and Human Services (the "Secretary"), in a time and manner designated by the Secretary, for purposes of determining CE's compliance with the Privacy Rule. Associate's Agent shall provide to CE a copy of any Protected Information that Associate's Agent provides to the Secretary concurrently with providing such Protected Information to the Secretary.j. Minimum Necessarv. Associate's Agent shall only request, use and disclose the minimum amount of Protected Information necessary to accomplish the purpose of the request, use or disclosure, in accordance with the Minimum Necessary requirements of the Privacy Rule including, but not limited to 45 C.F.R. Sections 164.502(b)and 164.514(d).k. Data Ownershio. Associate's Agent acknowledges that Associate's Agent has no ownership rights with respect to the Protected Information.l. Retention of Protected Information. Except upon termination of the Contract as provided in Section 4(d) of this Addendum, Associate's Agent shall retain all Protected Information throughout the term of the Contract and shall continue to maintain the information required under Section 2(h) of this Addendum for a period of six (6) years. m. Associate's Aqent's Insurance. Associate's Agent shall maintain casualty and liability insurance to cover loss of PHI data and claims based upon alleged violations of privacy rights through improper use or disclosure of PHl. All such policies shall meet or exceed the minimum insurance requirements of the Contract (e.9., occurrence basis, combined single dollar limits, annual aggregate dollar limits, additional insured status and notice of cancellation).n. Notification of Breach. During the term of the Contract, Associate's Agent shall notify Agent within twenty-four hours of any suspected or actual breach of security, intrusion or unauthorized use or disclosure of PHI and/or any actual or suspected use or disclosure of data in violation of any applicable federal or state laws or regulations. Associate's Agent shall take (i) prompt corrective action to cure any such deficiencies and (ii) any action pertaining to such unauthorized disclosure required by applicable federal and state laws and regulations. o. Audits. Inspection and Enforcement. Within ten (10) business days of a written request by CE, Associate's Agent shall allow CE to conduct a reasonable inspection of the facilities, systems, books, records, agreements, policies and procedures relating to the use or disclosure of Protected Information pursuant to this Addendum for the purpose of determining whether Associate's Agent has complied with this Addendum; provided, howevel, that:(i) Associate's Agent and CE shall mutually agree in advance upon the scope, timing and location of such an inspection; NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA E4 (ii) CE shall protect the confidentiality of all confidential and proprietary information of Associate's Agent to which CE has access during the course of such inspection; and(iii) CE shall execute a nondisclosure agreement, upon terms mutually agreed upon by the parties, if requested by Associate's Agent. The fact that CE inspects, or fails to inspect, or has the right to inspect Associate's Agent's facilities, systems, books, records, agreements, policies and procedures does not relieve Associate's Agent of its responsibility to comply with this Addendum, nor does CE's failure to detect, or detection but failure to notify Associate's Agent or require Associate's Agent's remediation of any unsatisfactory practices constitute acceptance of such practice or a waiver of CE's enforcement rights under the Contract. p. Safequards Durinq Transmission. Associate's Agent shall be responsible for using appropriate safeguards to maintain and ensure the confidentiality, privacy and security of Protected Information transmitted to CE or Associate pursuant to the Contract, in accordance with the standards and requirements of the Privacy Rule, untilsuch Protected Information is received by CE or Associate.q. Restrictions and Confidential Communications. Within ten (10) business days of notice by CE of a restriction upon uses or disclosures or request for confidential communications pursuant to 45 C.F.R. 164.522, Associate's Agent will restrict the use or disclosure of an individual's Protected Information, provided Associate's Agent has agreed to such a restriction. Associate's Agent will not respond directly to an individual's requests to restrict the use or disclosure of Protected Information or to send all communication of Protected Information to an alternate address. Associate's Agent will refer such requests to the CE so that the CE can coordinate and prepare a timely response to the requesting individual and provide direction to Associate's Agent. E.3. OBLIGATIONS OF COVEREND ENTITY (CE) a. Safequards Durinq Transmission. CE shall be responsible for using appropriate safeguards to maintain and ensure the confidentiality, privacy and security of PHI transmitted to Associate's Agent pursuant to the Contract, in accordance with the standards and requirements of the Privacy Rule, until such PHI is received by Associate's Agent. b. Notice of Chanoes. CE shall provide Associate's Agent with a copy of its notice of privacy practices produced in accordance with 45 C.F.R. Section 164.520, as well as any subsequent changes or limitation(s) to such notice, to the extent such changes or limitations may effect Associate's Agent's use or disclosure of Protected Information. CE shall provide Associate's Agent with any changes in, or revocation of, permission to use or disclose Protected Information, to the extent it may affect Associate's Agent's permitted or required uses or disclosures. To the extent that it may affect Associate's Agent permitted use or disclosure of PHl, CE shall notify Associate's Agent of any restriction on the use or disclosure of Protected Information that CE has agreed to in accordance with 45 C.F.R. Section 164.522. CE may effectuate any and all such notices of non-private information via posting on CE's web site. Associate's Agent shall review CE's designated web site for notice of changes to CE's HIPAA privacy policies and practices on the last day of each calendar quarter. NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA E5 E.4. TERMINATION a. MaterialBreach. In addition to any other provisions in the Contract regarding breach, a breach by Associate's Agent of any provision of this Addendum, as determined by Associate or CE, shallconstitute a material breach of the Contract and shall provide grounds for immediate termination of the Contract by Associate or CE pursuant to the provisions of the Contract covering termination for cause, if any. b. Reasonable Steps to Cure Breach. lf Associate or CE knows of a pattern of activity or practice of Associate's Agent that constitutes a material breach or violation of the Associate's Agent's obligations under the provisions of this Addendum or another arangement and does not terminate the Contract pursuant to Section 4(a), then Associate or CE shalltake reasonable steps to cure such breach or end such violation, as applicable. lf Associate's or CE's efforts to cure such breach or end such violation are unsuccessful, Associate or CE shall either (i) terminate the Contract, if feasible or (ii) if termination of the Contract is not feasible, CE shall report Associate's Agent's breach or violation to the Secretary of the U.S. Department of Health and Human Services. c. Judicial or Administrative Proceedinos. Either party may terminate the Contract, effective immediately, if (i) the other party is named as a defendant in a criminal proceeding for a violation of HIPAA, the HIPAA Regulations or other security or privacy laws or (ii) a finding or stipulation that the other party has violated any standard or requirement of HIPAA, the HIPAA Regulations or other security or privacy laws is made in any administrative or civil proceeding in which the party has been joined. d. Effect of Termination. (1) Except as provided in paragraph (2) of this subsection (d.), upon termination of the Contract, for any reason, Associate's Agent shall return or destroy all Protected Information that Associate's Agent still maintains in any form, and shall retain no copies of such Protected Information. lf Associate's Agent elects to destroy the PHl, Associate's Agent shall certify in writing to CE that such PHI has been destroyed. (2) lf Associate's Agent believes that returning or destroying the Protected Information is not feasible, Associate's Agent shall promptly provide CE notice of the conditions making return or destruction infeasible. Upon mutual agreement of CE and Associate's Agent that return or destruction of Protected Information is infeasible, Associate's Agent shall continue to extend the protections of Sections 2(a),2(b),2(c),2(d) and 2(e) of this Addendum to such information, and shall limit further use of such PHI to those purposes that make the return or destruction of such PHI infeasible. 5. Iniunctive Relief. CE shall have the right to injunctive and other equitable and legal relief against Associate's Agent or any of its subcontractors or agents in the event of any use or disclosure of Protected Information in violation of the Contract or applicable law.6. No Waiver of lmmunitv. No term or condition of the Contract shall be construed or interpreted as a waiver, express or implied, of any of the immunities, rights, benefits, protection, or other provisions of the Colorado Governmental lmmunity Act, CRS 24-10-101 el seg. or the FederalTort Claims Act, 28 U.S.C. 2671 et seg. as applicable, as now in effect or hereafter amended. NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Gontract OAA/OCA E6 7. Limitation of Liabilitv. Any limitation of Associate's Agent's liability in the Contract shall be inapplicable to the terms and conditions of this Addendum.8. Disclaimer. CE makes no warranty or representation that compliance by Associate's Agent with the Contract, HIPAA or the HIPAA Regulations will be adequate or satisfaciory for Associate's Agent's own purposes. Associate's Agent is solely responsible for all decisions made by Associate's Agent regarding the safeguarding of pHl. 9. Certification. To the extent that CE determines an examination is necessary in order to comply with CE's legal obligations pursuant to HIPAA relating to certification of its security practices, cE or its authorized agents or contractors, may, at cE's expense, examine Associate's Agent's facilities, systems, procedures and records as may be necessary for such agents or contractors to certify to CE the extent to which Associate's Agent's security safeguards comply with HIPAA, the HIPAA Regulations, or this Addendum. 10. Amendment. a. Amendment to Complv with Law. The parties acknowledge that state and federal laws relating to data security and privacy are rapidly evolving and that amendment of this Addendum may be required to provide for procedures to ensure compliance with such developments. The parties specifically agree to take such action as is necessary to implement the standards and requirements of HIPAA, the Privacy Rule, the Final HIPAA security regulations at 68 Fed. Reg. g334 (Feb20, 2OO3), 45 C.F.R. S 164.314 and other applicable laws relating to the security or privacy of PHl. The parties understand and agree that cE and Associate must receive satisfactory written assurance from Associate's Agent that Associate's Agent will adeq uately safeg uard a ll Protected I nformation. Upon the request of either party, the other party agrees to promptly enter into negotiations concerning the terms of an amendment to this Addendum embodying written assurances consistent with the standards and requirements of HIPAA, the Privacy Rule, or other applicable laws. Associate or CE may terminate the Contract upon thirty (30) days written notice in the event (i) Associate's Agent does not promptly enter into negotiations to amend the Contract when requested by CE pursuant to this Section or (ii) Associate's Agent does not enter into an amendment to the Contract providing assurances regarding the safeguarding of PHI that CE, in its sole discretion, deems sufficient to s-tisry tne standards and requirements of HIPAA and the Privacy Rule. 11. Assistance in Litiqation or Administrative Proceedinqs. Associate's Agent shall make itself available to CE and Associate , at no cost to CE or Associate, up to a maximum of thirty (30) hours to testify as witnesses, or otherwise in the event of litigation or administrative proceedings being commenced against Associate, its directors, officers or employees based upon a claimed violation of HIPAA, the Privacy Rule, or other laws relating to security and privacy or pHl, except where Associate's Agent is a named adverse party. 12. No Third Partv Beneficiaries. Nothing express or implied in the Contract is intended to confer, nor shall anything herein confer, upon any person other than cE, Associate, Associate's Agenf and their respective successors or assigns, any rights, remedies, obligations or liabilities whatsoever. NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA E7 13. Interpretation and Order of Precedence. The provisions of this Addendum shall prevail over any provisions in the Contract that may conflict or appear inconsistent with any provision in this Addendum. Together, the Contract and this Addendum shall be interpreted as broadly as necessary to implement and comply with HIPAA and the Privacy Rule. The parties agree that any ambiguity in the Contract shall be resolved in favor of a meaning that complies and is consistent with HIPAA and the Privacy Rule. The contract supersedes and replaces any previous separately executed HIPAA addendum between the parties. 14. Survival of Certain Contract Terms. Notwithstanding anything herein to the contrary, Associate's Agent's obligations under section 4(d) ("Effect of rermination") and section 12 ("No Third party Beneficiaries") shall survive termination of the Contract and shall be enforceable by Associate or CE as provided herein in the event of such failure to perform or comply by the Associate's Agent. This Addendum shall remain in effect during the term of the Contract including any extensions. 15. Representatives and Notice. a. Representatives. For the purpose of the Contract, the individuals identified elsewhere in the Contract shall be the representatives of the respective parties. lf no representatives are identified in the Contract, the individuals listed below are hereby designated as the parties' respective representatives for purposes of the Contract. Either party may from time to time designate in writing new or substitute representatives. b. Notices. All required notices shall be in writing and shall be hand delivered or given by certified or registered mail to the representatives at the addresses set forth below. AAA Representative: via Certified Mail Alpine Area Agency on Aging Northwest Colorado Council of Governments PO Box 2308 Silverthorne, Colorado 80498-23080 via Hand-Delivery Northwest Colorado Council of Governments 249Warren Avenue, Suite 101 Silverthorne, Colorado 80498 Title: viacertiried Mait,?O Qot hb0, e4lc-rCA tVa t via Hand-Derwew: 441 ?woAAut*y rErV, Co ?ilra I NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA E8 (a) EXHIBIT F E-VERIFY FEDERAL CONTRACTOR RULE EMPLOYMENT ELIGIBILITY VERIFICATION Definitions. As used in this clause- C o m m e rci al I y av a i I a b I e off-t h e - s h e lf (CO IS) ite rn-(1) Means any item of supply that is-(i) A commercial item (as defined in paragraph (1) of the definition at2.1O1);(ii) Sold in substantial quantities in the commercial marketplace; and (iii) Offered to the Government, without modification, in the same form in which it is sold in the commercial marketplace; and(2) Does not include bulk cargo, as defined in section 3 of the Shipping Act of 1984 (46 U.S.C. App. 1702), such as agricultural products and petroleum products. Per 46 CFR 525.1(c)(2), "bulk cargo" means cargo that is loaded and carried in bulk onboard ship without mark or count, in a loose unpackaged form, having homogenous characteristics. Bulk cargo loaded into intermodal equipment, except LASH or Seabee barges, is subject to mark and count and, therefore, ceases to be bulk cargo. Emptoyee assrgned to the contract means an employee who was hired after November 6, 1986, who is directly performing work, in the United States, under a contract that is required to include the clause prescribed at221803. An employee is not considered to be directly performing work under a contract if the employee-(1) Normally performs support work, such as indirect or overhead functions; and(2) Does not perform any substantial duties applicable to the contract. Subcontracf means any contract, as defined in 2.101, entered into by a subcontractor to furnish supplies or services for performance of a prime contractor a subcontract. lt includes but is not limited to purchase orders, and changes and modifications to purchase orders. Subcontracfor means any supplier, distributor, vendor, or firm that furnishes supplies or services to or for a prime Contractor or another subcontractor. United Sfafes, as defined in B U.S.C. 1101(a)(38), means the 50 States, the District of Columbia, Puerto Rico, Guam, and the U.S. Virgin lslands. Enrollment and verification requirements.(1) lf Contractor is not enrolled as a Federal Contractor in E-Verify at time of contract award, Contractor shall-(i) Enroll. Enroll as a Federal Contractor in the E-Verify program within 30 calendar days of contract award;(ii) Verify all new employees. Within 90 calendar days of enrollment in the E- Verify program, begin to use E-Verify to initiate verification of employment eligibility of all new hires of Contractor, who are working in the UnitedStates, whether or not assigned to the contract, within 3 business days after the date of hire (but see paragraph (bX3) of this section); and (iii) Verify employees assrgned to the contracf. For each employee assigned to the contract, initiate verification within 90 calendar days after date of (b) NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA F1 (2) enrollment or within 30 calendar days of the employee's assignment to the contract, whichever date is later (but see paragraph (bX4) of this section). lf Contractor is enrolled as a Federal Contractor in E-Verify at time of contraci award, contractor shall use E-Verify to initiate verification of employment eligibility of- (i) All new employees. (A) Enrolled 90 calendar days or more. Contractor shall initiate verification of all new hires of Contractor, who are working in the United States, whether or not assigned to the contract, within 3 business days after the date of hire (but see paragraph (bX3) of this section); or(B) Enrolledless than g0 calendar days. within 90 calendar days after enrollment as a Federal Contractor in E-Verify, Contractor shall initiate verification of all new hires of Gontractor, who are working in the United states, whether or not assigned to the contract, within 3 business days after the date of hire (but see paragraph (b)(3) of this section); or (ii) Employees assrgned to the contract. For each employee assigned to the contract, Contractor shall initiate verification within g0 calendar days after date of contract award or within 30 days after assignment to the contract, whichever date is later (but see paragraph (bXa) of this section). lf contractor is an institution of higher education (as defined at 20 u.s.c. 1001(a)); a State or local government or the government of a Federally recognized Indian tribe; or a surety performing under a takeover agreement entered into with a Federal agency pursuant to a performance bond; Contractor may choose to verify only employees assigned to the contract, whether existing employees or new hires. contractor shall follow the applicable verification requirements at (b)(1) or (b)(2), respectively, except that any requirement for verification of new employees applies only to new employees assigned to the contract.(4) Option to vertfy employment eligibility of all emptoyees. Contractor may elect to verify all existing employees hired after November 6, 1986, rather than just those employees assigned to the contract. Contractor shall initiate verification for each existing employee working in the United States who was hired after November 6. 1986, within 180 calendar days of-(i) Enrollment in the E-Verify program; or (ii) Notification to E-Verify Operations of Contractor's decision to exercise this option, using the contact information provided in the E-Verify program Memorandum of Understanding (MOU).(5) Contractor shall comply, for the period of performance of the Contract, with the requirements of the E-Verify program MOU. (i) The Department of Homeland security (DHS) or the sociar security Administration (SSA) may terminate Contractor's MOU and deny access to the E-Verify system in accordance with the terms of the MOU. In such case. contractor will be referred to a suspension or debarment officiar.(ii) During the period between termination of the MOU and a decision by the suspension or debarment official whether to suspend or debar, Contractor ls excused from its obligations under paragraph (b) of this clause. lf the suspension or debarment official determines not to suspend or debar Contractor, then Contractor must reenroll in E-Verify. (3) NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA F2 (c) Web site.Information on registration for and use of the E-Verify program can be obtained via the Internet at the Department of Homeland security web site: h,tp;//-ulu-dh-q.g-o-vl-E--:V--e.rf y, (d) lndividuals previously verified. Contractor is not required by this clause to perform additional employment verification using E-Verify for any employee-(1) Whose employment eligibility was previously verified by Contractor through the E-Verify program;(2) Who has been granted and holds an active U.S. Government security clearance for access to confidential, secret, or top secret information in accordance with the National Industrial Security Program Operating Manual; or(3) Who has undergone a completed background investigation and been issued credentials pursuant to Homeland Security Presidential Directive (HSPD)-12, Policy for a Common ldentification Standard for Federal Employees and Contractors. (e) Subcontracfs. Contractor shall include the requirements of this clause, including this paragraph (e) (appropriately modified for identification of the parties), in each subcontract that-(1) ls for- (i) Commercial or noncommercial services (except.for commercial services that are part of the purchase of a COTS item (or an item that would be a COTS item, but for minor modifications), performed by the COTS provider, and are normally provided for that COTS item); or (ii) Construction;(2) Has a value of more than $3,000; and(3) lncludes work performed in the United States. GONTRAGTOR:IV/A By: Title: Authorized Signature NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA F3 EXHIBIT G Example Option Letter OPTION LETTER 1,201 -June 30.201 Contract Name: PURCHASE OF SERVICES CONTRACT TITLE III OF THE OLDER STAT OL ance with cdfr between Council of Governments and-the NWCCOG hereby exercises its option for an additional term beginning Julv 1. 201 and ending June 30. 201 at an amount specified and for the service levels specified in the approved associated electronic SFY 201 -20'l Contract Year documents submitted via the Contract Reimbursement System. 3) ln accordance with Section - of the Original Contract the amount of funding is increased / decreased / remains unchanged as consideration for services ordered under the contract for the State Fiscal Year 2013-2014. The total amount of contract funding including anypreviousamendments,option|etters,etc'isuptobutnotexceedingatota|of$- 4) The following attachments are hereby incorporated to the Original Contract: - Option Letter No._; - the approved information contained in the electronic submission of the SFY 201 -2Ol Contract Year documents. The recitals mutually agreed to in the PURCHASE OF SERVICES CONTRACT TITLE ill OF THE OLDER AMERICANS ACT and STATE OF COLORADO OLDER COLORADANS ACT Contract Number and Exhibits, as amended, shall remain in fullforce and effect. The effective date of this Option Letter is upon approval of the Executive Director of the Northwest Colorado Council of Governments. NORTHWEST COLORADO COUNCIL OF GOVERNMENTS ALPINE AREA AGENCY ON AGING 249 Warren Avenue; PO Box 2308; Silverthorne, CO 80498 970-468-0295 (Federal lD Number 84-0639906) Dut"' f 1) 2) By: NWCCOG-Alpine Area Agency on Aging Revised 12.01.2015 Purchase of Services Contract OAA/OCA G1 CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY} 12t28t2015THlscERT|F|cATE|s|ssUEDAsAMATTERoF|NFoRMAT|oNot.lLYANDcoN CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIESBELow' THls CERTIFIGATE oF lNsuRANcE DoEs Nor coNsTlruiE A coNTRAcT BETwEEN THE tssulNc tNsURER(s), AUTHoRtzEDREPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. |MPoRTANT:|fthecertificateholderisanADD|T|oNAL|NsURED,thepoli"y(i" the terms and conditions of the policy, certain policies may require an "ndor"ern"nt. A statement on this certificate does not confer rights to thecertificate holder in lieu of such endorsementlsl_ Village CO 80111 r J._Gallagher Risk Management Services, Inc. S. Fiddlers Green Cir INSURED Eagle County P.O. Box 850 Eagle, CO 81631 383991 808 THIS IS TO CERTIFY THAT THE POLICIES Or IN INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTMCT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE tNsn wn POLICY NUMBER POI,MM'FF POLICY LIMlTS A X I coMMERCtAL GENERAL L|ABtLtTY I x I "*'"r-"oo. [l o""u*t- -- PER PARTICIPATION CERT 111t2016 111t2017 EACH OCCURRENCE $250,000 DAMAGE TO RENTED PREMISES (Ea occunence) MED EXP (Any one pe6on)$ PERSONAL & ADV INJURY $250,000 \].L AGGREGATE LIIVIIT APPLIES PER: I eoucv L_l iic"i I loc I otuen, GENEML AGGREGATE PRODUCTS - COIVIP/OP AGG $250,000 c A AU'a Xa IOMOBILE LIABILITY I nuvnuro lAbigy"o Il igf53,'.o HTREDAUTos fi-l |3lo3*"'" Claims Made fl PER PARTICIPATION CERT 1t'U2016 11112017 ,MtsINEU l'INGLE LIMI r accident)$zso.ooo BODILY INJURY (Per person)t BODILY INJURY (Per accident)D PROPERTY DAMAGE(Per acident)o $ B X UMBRELLA LIAB EXCESS LIAB x I occun_-l "*,".-too, 7910003550005 1t1t2016 1t1t2017 EACH OCCURRENCE $ 1 0,000,000 AGGREGATE $ 1 0,000,000 DED X I nerer.rrrous25o,ooo lWUKKEI{S (;OMPENSATION AND EMPLOYERS' LIABILITY ANy pRopRrEToRypARTNERyEXEcur,u= Fr OFFICERYMEI\4BER EXCLUDED? (Mandatory in NH) lf yes, describe under DESCRIPTION OF OPERATIoNS hclow N/A wcx0057883201 12t31t2015 12t31t2016 v trEK I totH- ^ISTATUTFI FR E.L. EACH ACCIDENT $ 1 ,000,000 E.L. DISEASE. EA EMPLOYEI $ 1 ,000.000 E.L. DISEASE. POLICY LIMIT 1.000.000 D A E County Workers' Comp Pool Prop, Mob Eq, Auto PD, XS Excess Property PER PARTICIPATION CERT. PER PARTICIPATION CERT 020412751 12t3',1201s 11112016 1t1t2016 12t31t2016 1t1t2017 11112017 )EDUCTTBLE $500 $ 150,000 3LANKET BLDG & PP $ lOO,OOO,OOO DEscRlPTloNoFoPERATloNs/LocATloNs/vEHlcLEs (AcoRDlol,Additional Remarksschedule,maybeattachedifmorespaceisrequired) WC SIR:$875.000 See Attached... 9!qtg ql Colorado, Division of Aging & Adutt Servrces 1575 Sherman, 1Oth Floor Denver CO 80203 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF, NOTICE WLL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORZED REPRESENTATIVE K^*-X"L^ @ 1988-2014 ACORD CORPORATION. Alt rights reserved. The ACORD name and logo are registered marks of AGORDACORD 25 (2014t0'tl o.#* AGENCY GUSTOMER ID: LOC #: ADDITIONAL REMARKS SCHEDULE 1 0f 1 AGENCY Arthur J. Gallagher Risk Management Services, Inc. NAMED INSURED Eagle County P.O. Box 850 Eagle, CO 81631 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, F9RM NUMBER: 25 FoRM TTTLE: CERTTFTCATE OF LtABlLtTy TNSURANCE ; Property: ': Lexington Insurance Company #020412751 Term: 011O112016 to 0110112017 100,000 Loss Limit - Excess Property/Real & Personal Property (All Risk) including Equipment )00,000 Each Occurrence/Annual Aggregate - Flood, Zone A ,990,000 Each Occurrence/Annual Aggr6gate - FlooiJ, all other Zones ,000,000 In the Aggregate as respects allilood loss combined 291000,000 Each Occu rrence/Annua I Aggregate - Earthquake 1q9,000 Fusiness Income (lncludes Renlat i-ncome) 150,000 Deductible All Pejils / $5,000 deductibte Equipment Breakdown except $10,000 appties tonake River Waste Water Treatment Facility in Dillori, CO D: CWCP is a qualified Self Insured Pool and is reinsured by Carrier C ;ate Holder is an Additional Insured as respects General Liability and auto Liability policies, pursuant to and subject to the policy'sdefinitions, conditions and exclusions. Services contract with the State of Colorado. ACORD 101 (2008/01)@ 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE TH|scERT|FlcATE|s|ssUEDAsAMATTERortruronualoNot.tlvn,t.tocoNFERs" :.tllllj"T-t"o:.=:[?]^ftIytllY:lY.9jI-E_SM5LY_AM ND, EXTEND oR ALTER rHE covERAGE AFFoRDED By rHE polrcrEsNE TVLIgIEDBELOW' THIS CERTIFICATE OF INSURANCE DOES NOT CONSTTTUTE A CONTRACT BETWEEN THE ISSU|NG TNSURER(S), AUTHORTZEDREPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. |MPoRTANT:lfthecert|ficateho|der|sanADDlT|onnr-tnsuneo,ttrepotrcy0es)mustb' ::""*:T:*1j":'l:'li::,T:::,::: tlillll31i,.,T^lorrcies may require an endorsement. A statement on this cerulcate does not conrer rrshts ro the ! _cq{laghel Risk Management Services, Inc. S. Fiddle/s Green Cir., #200 Greenwood Village CO 8011 1-4949 rNsuFED COLOCOU-o4 Eaole Countv P.d. Box gso Eagle, CO 81631 THIS IS TO CERTIFY THAT THE PoLICIES op II'II I IA I I NE TVLIVIED UT II\DUFII{NUtr LIU I EU 6ELUW HAVb tsEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODjl.T9['f^tP;-t^9y'Jlq]fl'fP$Rlfy^5E^9U^FFYEII-r-E!Y-91.-c-oryl|lo-ry oF ANY coNrmcr oR orHER DocuMENr wrrH RESpEcr ro wHrcH rHrscERrlFlcArE MAY BE lssuED oR MAy pERrArN, rHE rNsunnNcE AFFoFDED By rHE poLrcrEs DEScRTBEDft"Fi'$ll'is'ijuE;'cirt'o[;ill".'ftil5:EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. COMMEFCIAL GENERAL LIABILITY .LATMS-MADE fl o""r* GEN'L AGGREGATE LIMIT APPLIES PER: pnr rnvl lTIl4 | l'^^ OTHER: AUTOMOBILE LIABILITY ANY AUTO itrrgy*.o l-ISCHEDULED[----l NoN-owNEDHTREDAUToS I l;uibl BODILY INJURY (Per person) BODILY INJURY (Per accidenr) WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PBOPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUOED? (Mandatory in NH) E.L. DISEASE. EA EMPL Network Security and Privacy Liab 1t1t2016 Liability $1,000,000 DEscRlPTloNoFoPERATloNs/LocATloNs/VEHlcLEs (AcoRDlol,AddltonalRcmarkssch€dut€,maybeatiacheditmor.epacstsr€qutrad) lE: Services contract with the State of Colorado. LATION 9qtg 91 Colorado, Division of Aging & Adutr Services 1575 Sherman, 1Oth Floor Denver CO 80203 SHOULD ANY OF THE ABOVE DESCRIBEO POLtCtES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELTVEREO IN ACCORDANCE WITH THE POLICY PROVISIONS. @ 1988-2014 ACORD CORPORATTON. The ACORD name and logo are registered marks of ACORDACORD 25 (2o't4101) All rights reserved. tu DATE (MM'DD/YYYN 1212812015'K2J GERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND coNFERs No RIGHTS IJPoN THE GERTIFICATE HELDER iHisCERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIESBELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE |SSU|NG INSURER(S), AUTHORTZEDREPRESENTAT]VE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: lf the certificate hotder is an ADDITIONAL INSURED, the policy(ies1 must Ue enaorsed. lf SUBROGATION lS WAIVED, subject to-the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rightjto thecertificate holder in lieu of such endorsement(s). PRODUCER Arthur J. Gallagher Risk Management Services, Inc. t399 S. Fiddlers Green Cir Suite 200 3reenwood Village CO 80111 ixfiii'' Anita Bruner flt8N E",,,303€89-2s74 ll# ,., 303-889-2s7s !ffi!"=. anita_bruner@ajg.com INSURER(S) AFFORDING COVERAGE NAIC # TNSuRERA:Colorado Counties Casualtv & Prooer INSURED Eagle County P.O. Box 850 Eagle, CO 81631 tNsuRER B :Atlantic Specialtv lnsurance Comoan 27154 tNsuRER c:Arch Insurance Companv 11150 rNsuRER p :County Worker's Compensation Pool rnsunen e, Lexinqton Insurance comoanv 19437 INSURER F: 893132927 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE L INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THISCERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE luul INSD wvD POLICY NUMBER POLICY EFF .MM/DD/YYYYI LIMITS A X I coMMERCtAL GENERAL L|AB|LITY I x I GLA|MS-MADE | | OCCUR PER PARTICIPATION CERT 1t1t2016 1t1t2017 EACH OCCURRENCE $250,000 UAMAGE IORhNIID PRFMISFS fFa nenrrnp s MED EXP (AnV one Derson)s PERSONAL & ADV INJURY $250.000 ,I'L AGGREGATE LIMIT APPLIES PER:I f---l peo-lPoLrcYl ljEb:r I lLoc I ott.*, - GENEML AGGREGATE PRODUCTS - COMP/OP AGG $250,000 A AU' X X X .OMOBILE LIABILITY ANYAUTO ALLOWNED ] I SCHEDULEDAUTOS i I AUTOS H'REDAuros Fl l$+bo.*tt" Claims Made [l PER PARTICIPATION CERT 11112016 111t2017 UUMtrINEU JINgLts LIMI I(Ea accident)$zso,ooo BODILY INJURY (Per pe6on) BODILY INJURY (Per a@ident) PROPERW DAMAGE {Pcr accidcnll D B X UMBRELLA LIAB EXCESS LIAB X occun_l.*,r.-"oo.791 0003550005 1t1t2016 1t112017 EACH OCCURRENCE $ 1 0,000,000 AGGREGATE $ 10,000,000 oeo lX I RETENIoN$2so,ooo WORKERS COMPENSATION AND EMPLOYERS'LtABtLtTY YrN ANY PROPRIETOFYPARTNEFYEXECUTIVE T- OFFICER/MEMBER EXCLUDED? (Mandatory in NH) lf yes, describe under DESCRIPTION OF OPERATIoNS h€l^w N/A wcx005788320'l 12131t2015 12t31t2016 WIPER I IOTH- ^ISTATIITFI IFR E.L. EACH ACCIOENT 1.000.000 E.L. DISEASE - EA EMPLOYET $ 1.000.000 E.L. DISEASE. POLICY LIMIT $1.000.000 D A E County Workers' Comp Pool Prop, Mob Eq, Auto PD, XS Excess Prooertv PER PARTICIPATION CERT. PER PARTICIPATION CERT 020412751 12t31t2015 1t1t20'16 1t1t2016 12t31t2016 1t1t2017 1t1t2017 DEDUCTTBLE $500 $ 150,000 BLANKET BLDG & PP $ lOO,OOO,OOO DESCRIPTION OF OPEMTIONS / LOCATIONS / VEHICLES (ACORD 101, Addirional Remarks Schedule, may be atiached it more space is required) /UC SIR: $875,000 See Attached... CERTIFICATE HOLDER_ GANCELLATTON Alpine Area Agency on Aging Northwest Coi'oradil Couricit-ot Governments PO Box 2308 Silverthorne CO 80498 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVEV \}\4\-.s-*^ @ 1988-2014 ACORD CORPORATTON. Alt rights reserved. ACORD 25 (20141011 The ACORD name and logo are registered marks of AGORD AGENCY CUSTOMER ID: LOC #:,qf ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY \rthur J. Gallagher Risk Management Services, Inc. NAMED INSURED Eagle County P.O. Box 850 Eagle, CO 81631 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM. FoRM NUMBER: 25 FoRM TtrLE: CERTIFICATE OF LlABtLlry Property: ';. ^L^e1i1g_tq I nsurance Company #020412751 Term: 0110112016 to 01101t2e17 100'000 Loss Limit - Excess Property/Real & Personal Property (All Risk) including Equipment ,-09q1000 Each Occurrence/Annual Aggregate - Flood, Zone Aq,000,000 Each Occurrence/Annual Aggr6gate - Flooi, all other Zones 9,9qg,Qqq ln the Aggregate as respect-JaillooO toss combined ?q,,0ggl0q0 Each Occurrence/Annual Aggregate - Earthquake 1qq,ggO Business Income (lnctudes Reilat iircome) 150,000 Deductible All Pejils / $S,000 deductible E(uipment Breakdown except gl 0,000 applies tonake River Waste Water Treatment Facility in Dillori, CO D: CWCP is a qualified Self Insured Pool and is reinsured by Canier C cate Holder is an Additional Insured as respects General Liability and Auto Liability policies, pursuant to and subject to the policy's , definitions, conditions and exclusions. : Services Contract agreement ACORD 101 (2008/01)@ 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD tuAC:OR CERTIFICATE OF LIABILIry INSURANCE DATE ofirt/DD/YYYn 12t291201sIIII5 UEI{IIFIUAIE IS ISSUEO AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THISCERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLTCIESBELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTTTUTE A CONTRACT BETWEEN THE |SSU|NG TNSURER(S), AUTHORTZEDREpRESENTATTVE OR pRODUCER, AND THE CERTTFTCATE HOLDER. IMPORTANT: lf the certificate holder is an ADDITIoNAL lNsuRED, the policy(tes) must be endorsed. It suBRocATtoN ts wAtvED, sublecr tothe terms and conditions of the pollcy, certain policles may require an endorsement. A statement on thls cerilficate does not confer rlghts to thecertificate holder in lieu of such endorsement(s). PRODUCER fff u! _Gallagher Risk Management Services, Inc. 6399 S. Fiddler's Green Cir., #200 Greenwood Village CO 801 1i -4949 ixfi6"' Anita Bruner fil3\E" e.'' 303-889-2574 | f# "., 303-889-2575 i'dBilEss. anita_bru ner@ajg.com INSURER(S) AFFQRDING COVERAGE NAIC # lNsqRERA:lllinois Union Insurance Companv 27960TNSURED COLOCOU_o4 Eaole Countv P.d. Box gso Eagle, CO 81631 INSUREB B: INSURER C: INSURER D: INSURER E INSTJRER F: THIS IS TO CERTIFY THAT THE POLICIES OF INS INDICATED' NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIScERrlFlcArE MAY BE lssuED oR MAy pERrArN, rHE rNsuMNcE AFFoRDED By rHE polrcrEs DESoRTBE-ift-Fii:iN is suRii'c;fi'AiiilEEdilb:EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. COMMERCIAL GENERAL LIABILITY .LATMS-MADE fl o""r, GEN'L AGGREGATE LIMIT APPLIES PEF: tpan- I IPoLrcYl IjEbIT I lLoc OTHER: ANY AUTO AL+oWNED fl SoHEDULED T----'] NON-OWNEDHTREDAUToS j I aurbs BOOILY INJURY (Per p€rson) BODILY INJURY (Per accident) WORKERS COMPENSATION AND EMPLOYERS', LtABtLtW Y / NANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEiJBER EXCLUDED? (Mandatory in NH) E.L. EACH ACCIDENT Network Security and Privacy Liab Liability $1,000,000 DEscRlPTloNoFoPERAT|oNs/LocATloNs/vEHlclEs (AcoRDlol,AdditlonalRemarkaschoduts,maybqattacheditmorespacairrsquired) RE; Services Contract agreement CAN Alpine Area Agency on Aging Northwest Col-orado Couri'cil-of Governments PO Box 2308 Silverthorne CO 80498 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION OATE THER€OF, NOTICE WILL BE DELTVERED IN ACCORDANCE WITH THE POLICY PROVTSIONS. @ 1988-2014 ACORD CORPORAT|ON. Ail rights reseryed. The ACORD name and logo are registered marks of ACORDACORD 2s (2014101)