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HomeMy WebLinkAboutC97-289 Colorado Department of Public Health and EnvironmentC'97 28 9 0 4
26000 -- FAA
Contract Routing Number
9807555
Approved Waiver For
EMS County Subsidy Program
CONTRACT
THIS CONTRACT, made this 1st day of October 1997, by and between the State
of Colorado for the use and benefit of the Department of PUBLIC HEALTH AND
ENVIRONMENT, 4300 Cherry Creek Drive South Denver CO 80222, hereinafter
referred to as the State, and Eagle County P O Box 537 Eagle CO 81631
hereinafter referred to as the Contractor.
WHEREAS, authority exists in the Law and Funds have been budgeted,
appropriated and otherwise made available and a sufficient unencumbered balance
thereof remains available for payment in Fund Number 409. APPR code 845 ,
Contract Encumbrance Number FLA, EMS 9807555; and
WHEREAS, required approval, clearance and coordination has been accomplished
from and with appropriate agencies; and
WHEREAS, the Emergency Medical Services and Prevention Programs Division
("EMSP Division") was created to administer the County Subsidy Program created by
Title 25, Article 3.5, Part 6, C.R.S. ("Part 611); and
WHEREAS, the Emergency Medical Services Account within the Highway Users Tax
Fund was created by Title Sec. 25-3.5-603,C.R.S. to fund grants for the
enhancement of emergency medical services ("EMS") statewide; and
NOW THEREFORE, it is hereby agreed that for and in consideration of their
mutual promises to each other, hereinafter stated, the parties hereto agree as
follows:
1. The Contractor must enforce the provisions of Part 3 of the EMS Act -
licensing, inspecting, and regulation of ambulance and other pre -hospital care
providers to ensure that services are properly equipped, properly staffed, and
equipment and vehicles are safe and reliable. The Contractor will require all
licensed ambulance services to utilize the statewide emergency medical services
uniform prehospital care reporting system.
2. The Contractor will provide planning for the development, improvement, or
upgrade of emergency medical services. The aforementioned plan must satisfy the
requirements of section 25-3.5-605(c), Colorado Revised Statutes (as amended), be
submitted in a format approved by the EMSP Division on October 1st of each year,
with the first report due October 1, 1997, and any amendments to that plan must
be submitted by December 1st of each year. The parties hereby understand and
agree that the State will not be obligated to pay any funds pursuant to this
contract to the Contractor if the Contractor fails to submit the plan or amendment
to the plan by the dates specified above. This plan will be evaluated by the
State EMS Council, and payment of subsidy funds for the fiscal year will be
contingent upon State EMS Council approval of the plan.
3. All EMS transport providers within the County must comply with a statewide
data collection system in the format established by the State.
Page 1 of 6
4. The funds awarded herein must be spent in the manner described within
Attachment A, the Requirements for Expenditure of County Subsidy Funds. Funds not
expended consistent with section 25-3.5-605 and this contract will be returned to
the State.
5. The Contractor assures and guarantees that it possesses the legal authority
to enter into the Contract. The person or persons signing and executing this
contract on behalf of the Contractor do hereby warrant and guarantee that they
have full authorization to execute this Contract.
6. Anything herein to the contrary notwithstanding, the parties understand and
agree that all terms and conditions of this contract and the exhibits and
attachments hereto which may require continued performance or compliance beyond
the termination date of the contract shall survive such termination date and shall
be enforceable by the State as provided herein in the event of such failure to
perform or comply by the Contractor.
7. The Contractor will comply with the Americans with Disabilities Act at all
times during the performance of this contract. The Contractor certifies that no
qualified individual with a disability shall, by reason of such disability, be
excluded from participation in, or be denied the benefits of the services,
programs, or activities performed by the Contractor, or be subjected to any
discrimination by the Contractor upon which assurance the State relies.
8. For and in consideration of the Contractor's performance described herein
the State shall pay an amount not to exceed $14,618.92, Fourteen Thousand Six
Hundred Eighteen dollars and Ninety Two Cents on January 1, 1998, and payment will
be made upon the receipt of a request for payment signed by the Chairperson of the
Board of County commissioners. Such request shall be submitted in a form
established by the State, affirm compliance with the terms of the statute and this
contract, and be signed by an authorized representative of the Contractor.
Payment will be contingent upon affirmation by the EMSP Division of full and
satisfactory compliance with the terms of this contract Pursuant to section 25-
3.5-605(4)(a), a failure to comply with the statutory requirements of subsection
(2) shall render the Contractor ineligible to receive moneys from the emergency
medical services account until the following January. Payment for any renewal
period shall be on January 1 of that year, provided all reporting requirements are
complied with by October 1 of the previous year.
9. The Contractor is a "public entity" within the meaning of the Colorado
Governmental Immunity Act, C.R.S. 24-10-101, et seq., as amended ("Act"), the
Contractor shall at all times during the term of this Contract maintain such
liability insurance, by commercial policy or self-insurance, as is necessary to
meet its liabilities under the Act. The Contractor must provide the State with
proof of such insurance.
10. The term of this contract begins October 1, 1997 and continues through
December 31, 1998, and is renewable at the State's option for four (4) additional
one year periods by Contract Renewal Letter (copy attached and by this reference
made a part hereof as Attachment B) signed by the Contractor, the Colorado
Department of Public Health and Environment, and the State Controller or his
authorized designee. It is further understood that said Contract Renewal Letter
shall not be deemed valid until it is signed by the state Controller or his
authorized designee. Funding for any renewal period are subject to change from
prior contract periods based on actual funding appropriations and legislative
approval for each state fiscal year.
Page 2 of 6 Pages
f
COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT- hereinafter, under the General Contract
Provisions, referred to as "CDPHE".
GENERAL CONTRACT PROVISIONS -- page 1 of 2 pages
1. THE CONTRACTOR SHALL PERFORM ITS DUTIES HEREUNDER AS AN INDEPENDENT CONTRACTOR AND
NOT AS AN EMPLOYEE. NEITHER THE CONTRACTOR NOR ANY AGENT OR EMPLOYEE OF THE CONTRACTOR
SHALL BE OR SHALL BE DEEMED TO BE AN AGENT OR EMPLOYEE OF THE STATE. CONTRACTOR SHALL PAY
WHEN DUE ALL REQUIRED EMPLOYMENT TAXES AND INCOME TAX AND LOCAL HEAD TAX ON ANY MONIES
PAID PURSUANT TO THIS CONTRACT. CONTRACTOR ACKNOWLEDGES THAT THE CONTRACTOR AND ITS
EMPLOYEES ARE NOT ENTITLED TO UNEMPLOYMENT INSURANCE BENEFITS UNLESS THE CONTRACTOR OR
A THIRD PARTY PROVIDES SUCH COVERAGE AND THAT THE STATE DOES NOT PAY FOR OR OTHERWISE
PROVIDE SUCH COVERAGE. CONTRACTOR SHALL HAVE NO AUTHORIZATION, EXPRESS OR IMPLIED, TO BIND
THE STATE TO ANY AGREEMENTS, LIABILITY, OR UNDERSTANDING EXCEPT AS EXPRESSLY SET FORTH
HEREIN. CONTRACTOR SHALL PROVIDE AND KEEP IN FORCE WORKERS' COMPENSATION (AND SHOW PROOF
OF SUCH INSURANCE) AND UNEMPLOYMENT COMPENSATION INSURANCE IN AMOUNTS REQUIRED BY LAW,
AND SHALL BE SOLELY RESPONSIBLE FOR THE ACTS OF THE CONTRACTOR, ITS EMPLOYEES AND AGENTS.
2. Contractor authorizes CDPHE, or its agents, to perform audits and to make inspections for the purpose of evaluating
performance under this contract.
3. Either party shall have the right to terminate this agreement by giving the other party thirty days notice by registered mail,
return receipt requested. If notice is so given, this agreement shall terminate on the expiration of the thirty days, and the liability
of the parties hereunder for the further performance of the terms of this agreement shall thereupon cease, but the parties shall
not be relieved of the duty to perform their obligations up to the date of termination.
4. This agreement is intended as the complete integration of all understandings between the parties. No prior or
contemporaneous addition, deletion, or other amendment hereto shall have any force or effect whatsoever, unless embodied
herein in writing. No subsequent novation, renewal, addition, deletion, or other amendment hereto shall have any force or effect
unless embodied in a written contract executed and approved pursuant to the State Fiscal Rules.
5. If this contract involves the expenditure of federal funds, this contract is contingent upon continued availability of federal
funds for payment pursuant to the terms of this agreement. Contractor also agrees to fulfill the requirements of:
a) Office of Management and Budget Circulars A-87, A-21 or A-122, and A-102 or A-110, whichever is applicable;
b) the Hatch Act (5 U.S.C. 1501-1508) and Public Law 95-454 Section 4728. These statutes state that federal funds
cannot be used for partisan political purposes of any kind by any person or organization involved in the administration of
federally -assisted programs;
c) the Davis -Bacon Act (40 Stat. 1494, Mar. 3, 1921, Chap. 411, 40 U.S.C. 276A -276A-5). This act requires that all
laborers and mechanics employed by contractors or sub -contractors to work on construction projects financed by federal
assistance must be paid wages not less than those established for the locality of the project by the Secretary of Labor;
d) 42 U.S.C. 6101 et seq, 42 U.S.C. 2000d, 29 U.S.C. 794. These acts require that no person shall, on the grounds of
race, color, national origin, age, or handicap, be excluded from participation in or be subjected to discrimination in any program
or activity funded, in whole or in part, by federal funds;
Page 3 of 6 Pages
Rev. 05/07/97 (GEN)
GENERAL CONTRACT PROVISIONS -- Page 2 of 2 pages
e) the Americans with Disabilities Act (Public Law 101-336; 42 U.S.C. 12101, 12102, 12111 - 12117, 12131 - 12134,
12141 - 12150, 12161 - 12165, 12181 - 12189, 12201 - 12213 and 47 U.S.C. 225 and 47 U.S.C. 611;
f) if the contractor is acquiring real property and displacing households or businesses in the performance of this contract,
the contractor is in compliance with the Uniform Relocation Assistance and Real Property Acquisition Policies Act, as amended
(Public Law 91-646, as amended and Public Law 100-17, 101 Stat. 246 - 256); and
g) when applicable, the contractor is in compliance with the provisions of the "Uniform Administrative Requirements
for Grants and Cooperative Agreements to State and Local Governments" (Common Rule).
By signing and submitting this contract the contractor states that:
a) the contractor is in compliance with the requirements of the Drug -Free Workplace Act (Public Law 100-690 Title V,
Subtitle D, 41 U.S.C. 701 et seq.);
b) the contractor is not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily
excluded from covered transactions by any federal department or agency.
7. To be considered for payment, billings for payment pursuant to this contract must be received within 60 days after the
period for which payment is being requested and final billings on the contract must be received by CDPHE within 60 days after
the end of the contract term.
8. If applicable, Local Match is to be submitted on the monthly payment statements, in the column provided, as required
by the funding source.
9. If contractor receives federal funds in an aggregate amount per year from CDPHE which exceeds the applicable threshold
dollar amount specified in the Office of Management and Budget Circulars A-128 or A-133, contractor agrees to have an annual
audit, by an independent certified public accountant, which meets the requirements of Office of Management and Budget Circular
A-128 or A-133, whichever applies. If contractor is required to submit an annual indirect cost proposal to CDPHE for review
and approval, contractor's auditor will audit the proposal in accordance with the requirements of OMB Circular A-87, A-21 or
A-122. Contractor agrees to fumish one copy of the audit reports to the CDPHE Department Accounting Office within 30 days
of their issuance, but not later than nine months after the end of contractor's fiscal year. Contractor agrees to take appropriate
corrective action within six months of the report's issuance in instances of noncompliance with federal laws and regulations.
Contractor agrees to permit CDPHE or its agents to have access to its records and financial statements as necessary, and further
agrees to retain such records and financial statements for a period of three years after the date of issuance of the audit report. This
contract DOES NOT contain federal funds as of the date it is signed. This requirement is in addition to any other audit
requirements contained in other paragraphs within this contract.
10. Contractor agrees to not use federal funds to satisfy federal cost sharing and matching requirements unless approved in
writing by the appropriate federal agency.
Page 4 of 6 Pages
Rev. 05/07/97 (GEN)
SPECIAL PROVISIONS 0
CONTROLLER'S APPROVAL
I . This contract shall not be deemed valid until it shall have been approved by the Controller of the State of Colorado or such assistant as he may designate
This provision is applicable to any contract involving the payment of money by the State.
FUND AVAILABILITY
2. Financial obligations of the State of Colorado payable after the current fiscal year are contingent upon funds for that purpose being appropriated, budgeted
and otherwise made available.
BOND REQUIREMENT
3. If this contract involves the payment of more than fifty thousand dollars for the construction, erection, repair, maintenance, or improvement of any building,
road. bridge, viaduct, tunnel, excavation or other public work for this State, the contractor shall, before entering upon the performance of any such work included
in this contract, duly execute and deliver to the State official who will sign the contract, a good and sufficient bond or other acceptable surety to be approved
by said official in a penal sum not less than one-half of the total amount payable by the terms of this contract. Such bond shall be duly executed by a qualified
corporate surety conditioned upon the faithful performance of the contract and in addition, shall provide that if the contractor or his subcontractors fail to duly
pay for any labor, materials, team hire, sustenance, provisions, provendor or other supplies used or consumed by such contractor or his subcontractor in
performance of the work contracted to be done or fails to pay any person who supplies rental machinery, tools, or equipment in the prosecution of the work the
surety will pay the same in an amount not exceeding the sum specified in the bond, together with interest at the rate of eight per cent per annum. Unless such
bond is executed, delivered and filed, no claim in favor of the contractor arising under such contract shall be audited, allowed or paid. A certified or cashier's
check or a bank money order payable to the Treasurer of the State of Colorado may be accepted in lieu of a bond. This provision is in compliance with CRS
38-26-106.
INDEMNIFICATION
4. To the extent authorized by law, the contractor shall indemnify, save, and hold harmless the State, its employees and agents, against any and all claims,
damages, liability and court awards including costs, expenses, and attorney fees incurred as a result of any act or omission by the contractor, or its employees,
agents, subcontractors, or assignees pursuant to the terms of this contract.
DISCRIMINATION AND AFFIRMATIVE ACTION
5. The contractor agrees to comply with the letter and spirit of the Colorado Antidiscrimination Act of 1957, as amended, and other applicable law respecting
discrimination and unfair employment practices (CRS 24-34-402), and as required by Executive Order, Equal Opportunity and Affirmative Action, dated April
16, 1975. Pursuant thereto, the following provisions shall be contained in all State contracts or sub -contracts.
During the performance of this contract, the contractor agrees as follows:
(a) The contractor will not discriminate against any employee or applicant for employment because of race, creed, color, national origin, sex, marital status,
religion, ancestry, mental or physical handicap, or age. The contractor will take affirmative action to insure that applicants are employed, and that employees
are treated during employment, without regard to the above mentioned characteristics. Such action shall include, but not be limited to the following: employment
upgrading, demotion, or transfer, recruitment or recruitment advertisings; lay-offs or terminations; rates of pay or other forms of compensation; and selection
for training, including apprenticeship. The contractor agrees to post in conspicuous places, available to employees and applicants for employment, notices to
be provided by the contracting officer setting forth provisions of this non-discrimination clause.
(b) The contractor will, in all solicitations or advertisements for employees placed by or on behalf of the contractor, state that all qualified applicants will receive
consideration for employment without regard to race, creed, color, national origin, sex, marital status, religion, ancestry, mental or physical handicap, or age.
(c) The contractor will send to each labor union or representative of workers with which he has a collective bargaining agreement or other contract or
understanding, notice to be provided by the contracting officer, advising the labor union or workers' representative of the contractor's commitment under the
Executive Order, Equal Opportunity and Affirmative Action, dated April 16, 1975, and of the rules, regulations, and relevant Orders of the Governor.
(d) The contractor and labor unions will furnish all information and reports required by Executive Order, Equal Opportunity and Affirmative Action of April
16, 1975, and by the rules, regulations and Orders of the Governor, or pursuant thereto, and will permit access to his books, records, and accounts by the
contracting agency and the office of the Governor or his designee for purposes of investigation to ascertain compliance with such rules, regulations and orders.
(e) A labor organization will not exclude any individual otherwise qualified from full membership rights in such labor organization, or expel any such individual
from membership in such labor organization or discriminate against any of its members in the full enjoyment of work opportunity because of race, creed, color,
sex, national origin, or ancestry.
(f) A labor organization, or the employees or members thereof will not aid, abet, incite, compel or coerce the doing of any act defined in this contract to be
discriminatory or obstruct or prevent any person from complying with the provisions of this contract or any order issued thereunder; or attempt, either directly
or indirectly, to commit any act defined in this contract to be discriminatory.
(g) In the event of the contractor's non-compliance with the non-discrimination clauses of this contract or with any of such rules, regulations, or orders, this
contract may be canceled, terminated or suspended in whole or in part and the contractor may be declared ineligible for further State contracts in accordance
with procedures, authorized in Executive Order, Equal Opportunity and Affirmative Action of April 16, 1975 and the rules, regulations, or orders promulgated
Form 6 -AC -02B (GEN060197) Revised 06/01/97 Page 5 of 6 pages
;a rccordartce therewith, and such other sanctions as may be imposed and remedies as may be invoked as provided in Executive Order, Equal Opportunity and
Affirmative Action of April 16, 1975, or by rules,`rcgulations, or orders promulgated in accordance there- ' ti, or as otherwise provided by law.
(h) The contractor will include the provisions o�agraphs (a) through (h) in every sub -contract and subcontractor purchase order unless exempted by rules,
regulations, or orders issued pursuant to Executive Order, Equal Opportunity and Affirmative Action of April 16, 1975, so that such provisions will be binding
upon each subcontractor or vendor. The contractor will take such action with respect to any sub -contracting or purchase order as the contracting agency may
direct, as a means of enforcing such provisions, including sanctions for non-compliance; provided, however, that in the event the contractor becomes involved
in, or is threatened with, litigation, with the subcontractor or vendor as a result of such direction by the contracting agency, the contractor may request the State
of Colorado to enter into such litigation to protect the interest of the State of Colorado.
COLORADO LABOR PREFERENCE
6a. Provisions of CRS 8-17-101 & 102 for preference of Colorado labor are applicable to this contract if public works within the State are undertaken hereunder
and are financed in whole or in part by State funds.
b. When a construction contract for a public project is to be awarded to a bidder, a resident bidder shall be aflowed a preference against a non-resident bidder
from a state or foreign country equal to the preference given or required by the state or foreign country in which the non-resident bidder is a resident. If it is
determined by the officer responsible for awarding the bid that compliance with the subsection .06 may cause denial of federal funds which would otherwise
be available or would otherwise be inconsistent with requirements of Federal law, this subsection shall be suspended, but only to the extent necessary to prevent
denial of the moneys or to eliminate the inconsistency with Federal requirements (CRS 8-19-101 and 102).
GENERAL
7. The laws of the State of Colorado and rules and regulations issued pursuant thereto shall be applied in the interpretation, execution, and enforcement of this
eontram Any provision of this contract whether or not incorporated herein by reference which provides for arbitration by any extra judicial body or person
or which is otherwise in conflict with said laws, rules, and regulations shall be considered null and void. Nothing contained in any provision incorporated herein
by reference which purports to negate this or any other special provision in whole or in part shall be valid or enforceable or available in any action at law whether
by way of complaint, defense, or otherwise. Any provision rendered null and void by the operation of this provision will not invalidate the remainder of this
contract to the extent that the contract is capable of execution.
8. At all times during the performance of this contract, the Contractor shall strictly adhere to all applicable federal and state laws, rules, and regulations that
have been or may hereafter be established.
9. Pursuant to CRS 24-30-202.4 (as amended), the state controller may withhold debts owed to state agencies under the vendor offset intercept system for.
(a) unpaid child support debt or child support arrAarages; (b) unpaid balance of tax, accrued interest, or other charges specified in Article 22, Title 39, CRS;
(c) unpaid loans due to the student loan division of the department of higher education; (d) owed amounts required to be paid to the unemployment compensation
fund; and (e) other unpaid debts owing to the state or any agency thereof, the amount of which is found to be owing as a result of final agency determination
or reduced to judgment as certified by the controller.
10. The signatories aver that they are familiar with CRS 18-8-301, et seq., (Bribery and Corrupt Influences) and CRS 18-8-401, et seq., (Abuse of Public Office),
and that no violation of such provisions is present
11. The signatories aver that to their knowledge, no state employee has any personal or beneficial interest whatsoever in the service or property described herein.
IN WITNESS WHEREOF, the parties hereto have executed this Contract on the day first above written.
Contractor. Eagle County State of Colorado
% ROY ROMER, GOVERNOR
B
Pron(Irlitle) 846000762 N cna-t h Pep SOMI -
By
Social Security Number or Federal I.D. Number
If Corporation, Town/City/County, or Equivalent:
Attest (AM Seal) t;
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COLOF N
ATTORNEY GENERAL
Bev
vale A. Norton
Department
of PUBLIC HEALTH AND ENVIRONMENT
PROGRAM APPROVAL: ,X
QT__
APPROVALS
CONTROLLER
By
Clifford W. Hall
Foran 6 -AC -02C (GEN060197) Revised 06/01/97 Page 6 which is the last of 6 pages
ATTACHMENT A
REQUIREMENTS FOR EXPENDITURE OF COUNTY SUBSIDY FUNDS
County Subsidy funds provided by the State of Colorado, Department of Public Health & Environment, Emergency
Medical Services and Prevention Division, should be expended in the following manner.
I. HIGHEST PRIORITIES - SYSTEM BUILDING
1. Enforcing the provisions of Part 3 of the EMS Act - licensing, inspecting, and regulation of ambulance
services and other pre -hospital care providers to ensure that services are properly equipped, properly staffed, and
equipment and vehicles are safe and reliable. Funds can be used for salaries, regulatory activities associated with EMS,
test equipment, or other specifically related services and or supplies.
2. Planning for the development, improvement, or upgrade of emergency medical services. Funds may be
allocated for salaries, consulting fees, and other expenditures related to development or improvement of your County
EMS Plan.
3. County or Regional coordination between all agencies providing EMS and of EMS activities. This can
include but should not be limited to coordination of: training activities; planning; disaster exercises which include EMS
mass casualty drills; formulating a plan to meet OSHA regulations, etc. Funds may be used for creation and operation
of EMS councils (county or regional) and salaries for EMS coordinators.
II. WHEN YOU COUNTY PLAN DEMONSTRATES THAT ALL OF THE ABOVE ARE IN PLACE, you will then
be able to expend funds to achieve goals and objectives set forward in your approved County EMS Plan to provide
County EMS projects that improve EMS overall.
County Subsidy funds must be expended within the calendar year of receiving them, unless otherwise approved by the
Division for EMSP.
III. INAPPROPRIATE EXPENDITURE OF FUNDS WILL INCLUDE, BUT NOT BE LIMITED TO:
1. Supplanting funds which have been previously allocated by the county for EMS.
2. Expenditure for equipment or services that are not directly related to emergency medical services and do
not afford any direct improvement or maintenance of the existing system/s.
3. Salaries for personnel that do not have within their job description, responsibility for planning, coordination
or regulation of emergency medical services; to include both medical and non-medical aspects.
4.These funds cannot be used as match to the EMSP grants program.
Attac'
STATE OF
Roy Romer, Governor
Patti Shwayder, Executive Director
Dedicated to protecting and improving the health and environment of the people of Colorado
4300 Cherry Creek Dr. S.
Denver, Colorado 80222-1530
Phone (303) 692-2000
, 1996
State Fiscal Year 19_ - _
Contract Renewal Letter No.
Laboratory Building
4210 E. 11 th Avenue
Denver, Colorado 80220-3716
(303) 6914700
-�nt B
COLORADO
Contract Routing Number
Colorado Department
of Public Health
and Environment
In accordance with Paragraph _ of the contract with routing number and contract number . (as amended
by Change Order Letter routing number , and/or Renewal Letter routing number ), hereinafter referred to
as the Original Contract (copy attached and by this reference made a part hereof) between the State of Colorado, Department
of Public Health and Environment ( Division) and . the parties hereby
agree the Original Contract is hereby renewed for the period of 199_ through 199_. The
parties agree that the maximum amount payable by the State for the eligible services during this renewal period is
DOLLARS ($_ ) according to the work plan attached hereto as Attachment A and the budget
attached hereto as Attachment B, both incorporated herein. The terms of conditions of the Original Contract are hereby
reaffirmed and shall continue in full force and effect throughout this renewal period unless otherwise stated.
This amendment to the Original Contract is intended to be effective as of 199_, but in no event shall it be
deemed valid until it shall have been approved by the State Controller or such assistant as he may designate.
Please sign, date and return all_ originals of this letter as soon as possible to:
Colorado Department of Public Health and Environment
Division
Mail Code:
4300 Cherry Creek Drive South
Denver, Colorado 80222-1530
One original of this letter will be returned to you when fully approved.
Contractor: State of Colorado:
Full Contractor Name Roy Romer, Governor
By:
Signature
Print Name:
Title:
APPROVALS:
PROGRAM
By:
By:
For the Executive Director
Colorado Department of Public Health
and Environment
APPROVALS:
CONTROLLER
By:
Clifford W. Hall