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HomeMy WebLinkAboutC02-151 CDPHEc� 5/-z z-
`� STATE OF COLORADO
Bill Owens, Governor
Jane E. Norton, Executive Director
Dedicated to protecting and improving the health and environment of the people of Colorado
4300 Cherry Creek Dr. S.
Laboratory and Radiation Services Division
Denver, Colorado 80246-1530
8100 Lowry Blvd.
Phone (303) 692-2000
Denver, Colorado 80230-6928
TDD Line (303) 691-7700
(303) 692-3090
Located in Glendale, Colorado
httpAvww.cdphe.state.co.us
July 1, 2002
State Fiscal Year 2002 — 200-1 Contract Renewal Letter Number 03,
Colorado Department
of Public Health
and Environment
Contract Routing Number 03-00011
Pursuant to Section C, 8. of the Contract with contract routing number 00 FHA 00017 and contract encumbrance number PO
FHA EPI 0000017. (as amended by Contract Renewal Letter number 01 contract routing number 01-00013 and Contract
Renewal Letter number 02, contract routing number 02-00011) hereinafter referred to as the "Original Contract"(a copy of
which is attached hereto and by this reference incorporated herein and made a part hereof) between the State of Colorado,
DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT and the EAGLE COUNTY HEALTH AND HUMAN
SERVICES, for the renewal term from July 1. 2002, through June 30, 2003, the parties agree that the maximum amount
payable by the State for the eligible services referenced in: Section B. of the Original Contract is increased by SEVEN
($6,080.00); and, that the Blanket Encumbrance amount in Section C.1, B. of the Original
Contract is decreased to TWENTY TWO THOUSAND EIGHT HUNDRED FIFTY DOLLARS ($22,850.00) for
Tuberculosis Direct Observed Therapy for State Fiscal Year 2003 Statewide for a new total financial obligation of the
State of TWENTY FIVE THOUSAND FOUR HUNDRED EIGHTY TWO DOLLARS, ($25,482.00). The revised
reimbursement schedule is outlined in the budget below. The first sentence in Section C,1. of the Original Contract is hereby
modified accordingly. All other terms and conditions of the Original Contract are hereby reaffirmed. This amendment to the
Original Contract is intended to be effective as of July 1, 2002. However, in no event shall this amendment be deemed valid
until it shall have been approved by the State Controller or such assistant as he may designate.
Budget
TB Control
July 1, 2002 - June 30, 2003
Description of Reimbursement
Tuberculosis Control Services
Direct Observed Therapy @ $12.50/visit
Amount Fundina Source
$6,080.00 State
As Administered State
Total $6,080.00
Please sign, and return all 4 originals of this Contract Renewal Letter to the attention of Marti Wood, Colorado Department
of Public Health and Environment, 4300 Cherry Creek Drive South, Denver, Colorado 80246, Mail Code: DCEED TB
A-3. One original of this Contract Renewal Letter will be returned to you when fully approved.
Page 1 of 2 Pages
H:IContractslTBContracts02&031Eagle03.doc
Created by Marti Wood
Last printed 5/15/02 10:30 AM
EAGLE COUNTY HEALTH AND
HUMAN SERVICES
(a political subdivision of State o olo
By:
Print Name: !�
Title:
FEIN: 846000762
OFFICE OF THE STATE CONTROLLER:
Arthur L. Barnhart, State Controller
By:
H:1Contracts\TBCantracts02&031Eagle03.doc
Created by Marti Wood
Last printed 5115102 10:30 AM
STATE OF COLORADO
...-_ ,6'Bill Owens, Governor
UO �G
By:
* For the Executive Director
aE.ORPp0 DEPARTMENT OF PUBLIC HEALTH
AND ENVIRONMENT
APPROVALS:
By:
Page 2 of 2 Pages
PROGRAM:
Eric Schleiger, Fiscal Officer
DISTRIBUTION
Originals to:
1.
Contract Book
2.
3.
4.
Copies to:
I.
Accounting
2.
3.
4