HomeMy WebLinkAboutC02-128 CDPHEC 021 --- IZ F-
` -STATE
Bill Owens, Governor
Jane E. Norton, Executive Director
OF COLORADO
Dedicated to protecting and improving the 'health and environment of the people of Colorado
4300 Cherry Creek Dr. S.
Denver, Colorado 80246-1 S30
Phone (303) 692-2000
TDD Line (303) 691-7700
Located in Glendale, Colorado
httpV1www.cdphe.state.co.us
May 1, 2002
Laboratory and Radiation Services Division
8100 Lowry, Blvd.
Denver, Colorado 80230-6928
(303) 692-3090
Contract Change Order Letter Number 4
State Fiscal Year 2001- 2002.
Contract Change Order Letter
h
18?6
Colorado Department
of Public Health
and Environment
Contract Routing Number 02 FAA 01019
Early and Periodic Screening Diagnosis and Treatment (EPSDT) Proeram
This Contract Change Order Letter is issued pursuant to paragraph C. 5. of the Contract with contract routing number 99 FAA 00499 and
contract encumbrance number PO FAA EPS9900499, between the COLORADO DEPARTMENT OF PUBLIC HEALTH AND
ENVIRONMENT and BOARD OF COUNTY COMMISSIONERS OF EAGLE COUNTY. *The Contract has been amended by
Contract Renewal Letter 1 contract routing number 00 FAA 00022, Contract Renewal Letter ccontract routing number 01 FAA 00176,
Contract Renewal- Letter 3 'contract routing number 02 FAA 00103, Contract Change Order Letter 1 contract routing number 99 FAA
01530, Contract Change Order Letter 2 contract routing number 00 FAA 01124, and Contract Change Order Letter 3 contract routing
number 01 FAA 01189. The Contract, as amended, if applicable, is referred to as the "Original Contract". A copy of the Original Contract
is incorporated herein by this reference, made 'a part hereof, and attached hereto unless a Letter of Compliance has been submitted with this
Contract Change Order Letter. This Contract Change Order Letter is for the current term of July 1, 2001, through June 30, 2002. The
maximum amount payable by the State for the work to be performed by the Contractor during this current term is decreased by FIVE
HUNDRED SIXTY-SIX DOLLARS, 5($ 66.0 for an amended total financial obligation of the State of FORTY-FOUR THOUSAND
NINE HUNDRED TWENTY-NINE DOLLARS_, (S44,929.00). The revised Budget is incorporated herein by this reference, made a part
hereof, and attached hereto as "Attachment 2-3". The first sentence in paragraph C.1. of the Original Contract is modified accordingly.
All other temis and conditions of the Original Contract are reaffirmed. The proposed effective date of this Contract Change Order Letter is
May 27, 2002. However, in accordance with section 24-30-202, C.R.S., as amended, in no event shall this Contract Change Order Letter
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 FOUR (4) originals of this Contract Change Order Letter as soon as possible, to the attention of: Peggy
Becker, Colorado Department of Public Health and Environment, 4300 Cherry Creek Drive South, Denver, Colorado 80246-1530,
Mail Code: PSD-HCP-A4. One original of this Contract Change Order Letter will be returned to you when fully approved.
BOARD OF COUNTY COMMISSIONERS
OF EAGLE COUNTY
(a political subdivision of the state of Colorado)
By:
Names
Title:
FEIN:
Date:
FOR THE STATE CONTROLLER:
Arthur L. Barnhart, State Controller
By:
Date:
010�
:V1CPC0=wn\C0KrRACI WSUM M\&gWs FY02 COL&C
STATE OF COLORADO
Bill Owens, Governor
By:
For the Executive Director
DEPARTMENT OF PUBLIC HEALTH
AND ENVIRONMENT
PROGRAM APPROVAL:
b
ATTACHMENT 2-3
REVISED APRIL 23, 2002 VACSAV
APPLICANT: Eagle
PROJECT: EPSDT
nFTe11 Fn R11nr;FT FOR THE PERIOD! July 1.2001 to June 30.2002
Annual Number
Total
Applicant
Requested
EPSDT
DIRECT COST Salary Months % Time
Amount
Rate Budget
Required
and Other
from CDH
PERSONNEL SERVICES: 0.35
Stone 29,765 12.00 10%
2,976
2,976
2,976
Ontiveros 27,290 12 10%
2,729
2,729
2,729
Grant 26,998 '12 15%
4,050
4,050
4,050
Plus additional funds for FY02 Salaly & Fr. Increases
272
272
272
LESS VACANCY SAVINGS
-566
-566
-566
Contractual/Fee for Service:
Supervising Personnel:
Sarah Schipper 55,937 12 5%
2,797
2,797
Fringe Benefits Rate =
2,313
2,313
2,313
Total Personnel Services
14,571
2,797
11,774
11,774
OPERATING EXPENSES:
(includes Building/Facility
Cost not part of Indirect)
Operating
704
704
Subtotal Operating
704
704
TRAVEL:
423
423
Subtotal Travel
423
423
EQUIPMENT:
Subtotal Equipment
Total Direct Costs Pers.+0 eratin +Travel+E ui
15,6981
3,9241
11,774
11,774.
Administrative/Indirect Cost
TOTAL PROJECT COST
1 15,6981
3,9241
11,7741
11,774
Source of Funding for "Applicant and Other"
3,924
Total Applicant and Other $3,924
"This contract will pay the actual approved rate for indirect costs tmanzea Dy the t;oioraao uepartment
of Public Health and Environment and subject to the maximum rates allowed by the Family and Community
Health Services Division. The finalized rate will be retroactive to the beginning of the contract.
EAG�BOARD OF COUNTY COMMISS�IERS
AGENDA REQUEST & STAFF RECOMMENDATION FORM
TITLE EPSDT Change Order No. 4 - Early, Periodic, Screening, Diagnosis and
Treatment
LOCATION Eagle County Room
STAFF CONTACT/PRESENTER Kathleen Forinash
DEPARTMENT Health & Human Services
REQUESTED HEARING DATE 5/28-02 (1 ST CHOICE)1 (2"d choice)
CHECK ONE:
CONSENT CALENDAR X ON THE RECORD WORK SESSION
LENGTH OF TIME REQUESTEDIREQUIRED
THE DOCUMENTS TO BE SIGNED HAVE BEEN REVIEWED & APPROVED BY THE
COUNTY ATTORNEY
County Attorney
IF THIS IS A CONTRACT OR OTHER ITEM REQUIRING AN EXPENDITURE, IS THE
FULLAMOUNTTO COVERTHIS REQUEST IN THE CURRENTAPPROVED BUDGET?
001-2210-0062-0000-1540
PROJECT/CONTRACT DESCRIPTION_
In the third quarter of each state fiscal year, the Colorado Department of Public Health and
Environment reviews the current and anticipated spending levels for the EPSDT, Early
Periodic Screening, Diagnosis and Treatment program, and makes adjustments to the
county's contract. The Eagle County contract is being adjusted downward by $ 566.
STAFF RECOMMENDATION To sign the Change Order Letter No. 4 for contract
00-01188 with the State of Colorado Department of Public Health and Environment.
Jack Ingstad, County Administrator
