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HomeMy WebLinkAboutC81-071 CDPHE�S1:NT 0R AGENCY NU.Nit3FR ! i (:0NTR.\CT THIS C ON'I'E1:1( I. made tl►is �,, 1 LiL_ d:ty 19 1 by and bete: cell the State of' Colorado for the trse and benefit of tite !k•liarttnent of ��.�;lld--C�1.I.1_d•-Li�a1_��_5�'ry i .:es------ ----------------� .�.�_-- --- - ---- -- r - — - hervinafter referred to as the Stme, and _JHE_BQARD QF _CQjM1TY_Qr)rif-I I SS I OIJERS 1 EAGLE COUNTY Ea.gJ.e,_-Colorado.�.1G31__---_�____-------— hercinafter refereed to as the contractor, ►NHEREAS. atithurity exists in the Law and Funds have been budgeted, appropriated and otherwise nudt: :nailable and a sufficient unVncfrftibered bal.ince thereof remains available for paytncnt in Fund Numb er C'I. Account Nurtti►rr � r'-' _' (:ontrart hnrufrthr:tncc ��urt;l her C29�'Ol 4 and 1-�- f----- Will-REAS. required apprtj%al, clearance and coordination lias been acco,n;►fished from and with approhriato aIeneies; Mid IVIIERFAS. '3 the State has been awarded monies to "A Proposal For a Contract to Provide Cast: lia ageinent and Outreach to Eli igihle E_.P.S.D.l . Fat'lii i(2s (Larly and Periodic Screening, Diagnosis arld Tre�l�,►:;ent1" ��;T the Colorado i,ient of Social Services; arid WNIEREAS, the said "Proposal " calls for cast' ini anaC{ement and outreach acti vi iE's to be impl erlu_nted hrough subcontracts %vii th local heal t-h agencies; and WHE'REAS, the State will contract with the contrac4. tor to assure that Mledicaid ch i 1 dren eligible for EPSDT receive preventive and curative meal tie care and treat- ment and that the families of said children are i ri, owned about the benefits of health prevention and promotion in such a :•i�-iy as to encourage their participation in the EPSDT program. 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 will perform an EPSDT outreach component by contacting <EPSDT-eligible families in Eagle _ county (i es) on the priority basis as designated ii n tole "Proposa 1 " to explain the value of EPSDT and the importance of preventive health care measures and to offer and provide assistance in overcoming obstacles for obtaining EPSDT services. 2. The contractor shall be responsible for carrying out the activities as defined by the October- 1, 1979 EPSDT Regulations and making any changes in procedures which may be warranted by Federal audits. 3. The contractor shall provide to the Colorado Department of Health on a monthly basis information documenting contact and case management procedures, in accordance with the written directives of the State. 4. Upon written notification, by Social Services of impl ementati on of 11,11ed i ca i d Management Information System (MIIIS), contractor shall utilize the IMMIS information for individual case management activities where appropriate. 5. The contractor shall document and make available the folio%-.i ng i nfor illation to the Colorado Department of Social Services and/or federal auditors upon receipt of a written request from the State: a. The date a recipient was contacted by the contractor. b. The date(s) a recipient requested assistance for EPSDT services and the date(s) a recipient refused assistance for EPSDT and reason, if possible. c. The date the recipient was offered initial or periodic EPSDT services and the date of declination of services. d. The name and address of provider chosen by recipient. e. The names of AFDC families or recipients who chose to receive services from a provider who does not provide the full range of EPSDT services, the date on which they requested services that are not covered by that provider, and the dates that the requested services were provided. f . The type of support services provided to a recipient, e . g . , trails por- tation, scheduling of appointments. 31-15-53.01-c010 • P:we I of—L patles '(See instructions on revers: of last page.) \..f b.r/ CONTRACT 114 � g. The date EPSDT services were provided to the recipient as reported by the recipient. h. Documentation and reasons for all recipients requiring no further case management responsibility; e.g., number refusing assistance, break- ing appointments for initial or follo:i-up screen, no longer eligible. i. Documentation of follow-up to ascertain if treatnient was provided. j . The names of the recipients who required treatment for conditions not covered by the plan and documentation of the efforts to refer them to providers willing to treat them at little or no expense to the family. k. Dates of all periodic recontact. 1. Documentation of referral, when needed, to Title V programs. 6. The contractor shall assist families requiring transportation to providers of EPSDT services in obtaining said transportation in the most cost efficient and reasonable manner possible. 7. The contractor shall assure that all personnel employed to provide EPSDT outreach and case management activities will receive professional supervision by public health nursing personnel or other skilled medical personnel. 8. The contractor will assure that all personnel assigned to perform EPSDT outreach and case management activities will be available for all training to be deemed necessary. 9. The State will, in consideration of said services and reporting by the contractor, cause to be paid to the contractor a sum not to exceed Three Thousand Seven Hundred Hinety-Fight and no/100 Dollars (.t3,7.98.00) \.r' in the following manner, subject to verification by the State of full and satis- factory compliance with the terms of the contract; including, but not limited to: a. Upon receipt by the State of a signed monthly statement in triplicate from the contractor requesting reimbursement, in accordance with the cate- gori-es and line items of the budget set forth in Attachment A of this con- tract. Said statement shall also report amounts expended from matching funds if such funds have been stipulated in the budget, Attachment A, of this contract. Monthly statements shall be rendered by the contractor, In conformity with the format to be supplied to the contractor by the State. An initial supply of the subject statement forms will be supplied to the contractor and additional forms as requested thereafter. b. Satisfactory compliance with all reporting requirements as set forth in this contract. 10. This contract is not assignable without written consent of the State. 11. Expenditures of funds by the contractor shall be governed by the budget, Attachment A, which by this reference is incorporated herein. Transfers of funds from one category or line item by the contractor must have the prior, written approval of the State. 12. The term of this contract is from July 1, 1931 through June 30, 1982. 13. Time Is of the essence in the performance of this contract. 14. All material and information provided to the contractor by the State or obtained by the contractor pursuant to its duties hereunder shall be regarded as confidential and all necessary steps shall be taken by the contractor to safeguard the confidentiality of such material and information in conformance with Federal and State laws and regulations. Page-2 of 5 pages COLORADO DEPARTMENT OF HEALTH - hereinafter, under the General Provisions, r referred to as "Health". GENERAL PROVISIONS u The parties of this Contract intend that the relationship between them contemplated by this Contract is that of employer -independent contractor. No agent, employee, or servant of Contractor shall be or shall be deemed to be an employee, agent, or servant of Health. Contractor will be solely and entirely responsible for its acts and the acts of its agents, employees, servants, and subcontractors during the performance of this Contract. At all times during the performance of this Contract, the Contractor shall strictly adhere to all applicable federal and state laws that have been or may hereafter be established. Contractor authorizes Health to perform audits and to make inspections for the purpose of evaluating performance under this Contract. Contractor shall indemnify Health against all liability and loss, and against all claims and actions based upon or arising out of damage or injury, including death, to persons or property caused by or sustained in \fto, connection with the performance of the Contract or by conditions created thereby, or based upon any violation of any statute, ordinance, or regula- tion and the defense of any such claims or actions. 1%Wp✓ t r- 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. 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 whatso- ever, 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. 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. If this contract includes reimbursement for personal services, payrolls must be supported by time and attendance or equivalent records for individual employees. Salaries and wages of employees chargeable to more than one grant program or other cost objective will be supported by appro- priate time distribution records. Copies of time certifications shall ac- company billings for the period to which they apply. To be considered for payment, billings for reimbursement pursuant to this contract must be received within 60 days after the period for which reimbursement is being requested and final billings on the contract must be received by the State Health Department within 60 days after the end of the contract term. Page 3 * of 5 pages lwill11 M 0213 C'Oti"I�ftOLL(;IZ'S :�pf'ltU1' �1L� w"I'� �� i. j�lls contract shall Ilfi( lit' dt'Cmed \;dill on.11I II ��I.W Il;lti : t r'• '.1.. !. :,,!Irnil. i' i,! illy ;;t'. t Colorado or Stich ati.I.Iant as lie i,l+)!i 1, ;'I•:1i.. .. .•, �; !..;. I nIoI1C\' by (lit.` State. FUND AVAILABILITY 2. Financial obll,-'alions lit tilt' S1,11C pa\'al)il• after Jilt' :llrt''I►! t:','::! tt':Ir ::R' l'r,:1!t11_'tl11 upin liillll, till' purpose being appropriated. budgeted and other\\'i.e Inadc ,\,habit. \°1r BOND RL-QUIIZI:111:INT Z. if this contract Invttl\e,, tilt_' p:l\'lllt•!it t)t IilorC Itiall tell 1!1,111%all:! th"I , i1i:'-!1I t.Ilt:!I. ... :!aril. • . i'::;! maintenance, or Improvement tit any bliddlill.. r'ti,td, itllliit'I, t'kt...\:ttliiil ttr i%'tit:! !,tlti!:_' State, (lie contractor shall, bett►rc entering upon till' pe'llmillan,•e of Intlucictl I:l thIN CXCcutC and deliver to Mid file \\i(tl the olficial xho%c .!,'naturr appcw, t,i !i '.\ for ;!Ic State, a bt►nd or other acceptable Surety it) he approved by .aid olficlal in ;I pt•nal ,uln no, " .• than anwunt pa\ablc by the terms of till. contract. Such hand .iiali hr tiul\ nccutcd !•.\ .t uttalhlicJ :t,!I,t:r:it 1: ctlndltltirled }or the due and faithi*lil performance of the contract. -and 11' :it} j111oll. "!sail prokidt• tfi:lt It t:iC hi. subcontractors fail it) duly pal for any labor, matcri:d., tra::: I,.![ M.". supplies used t)r' consumed by .licit contia toi or Ills .ub1ContrIC101 III itc!oviliallte tit tilt' he .. .., (Ill.' .tlrC(\' Will psi`. the .,rile III ;ll1 arlIOUnt not exceeding (Ile punt shClil!ea !!i It!e hond. 1t,gether %w!i lntt'rv-! 11 !!1_- [-;Ile of e1011 per cent per annuls U-111Cs1, suCh b0ild, '•\'11C:1 `:o rt't11111-t'tl, I, CWttltccl, t!Cfl'-CrCd Mid 'lief'. tit: favor of the contractor :wising under this Contract shall he ILIdI(Cd. tlllowcd or pall. A c�:rnfied ur c'a:,lllet''.-t ; bank money order made payable to the Treasurer of tilt' suac tit Colorad') ilia` the act't•iiii_d ill IClll it; ;t MINIMUM WAGE 4. Except as otherwise provided by law, if this contmc•t provides for file pa :'i11e!It of more ihan'i•.. dollars and requires or involves the eniploymem of laborers or ill flit: run•tructitin, alteration ,r r: ,,.,:, :)! alt\, hisildim - or other public work, (e\eept hi,,01wav brith,e.. IIIIderp:l..r; and hi ll\r;:\' �trurtus ,i : ll kinds) within the geographical limits of thr State, the rate of w:Il.:e fur all kiborcr-z and :11ech:lilies rlt1,)I1f t•_i !pt contractor or any subcontractor on the buildint- or public: \work .'t)\ered b\ tlli. comrat't .hall lie not !t ii!:,:: !,. prevailing rate of \%age's for \\'or•k of :I similar naturt' in tilt' city, to\\'n, I Wage or ollwr CI\'ii ,tjhdivi Ji: ;i !,! 'I!-- ;I; Mlich tilt• building or other public work i. located. Ui.putr, re.pccting prevailin rates \vill he resoty+.-d a, ,)r,:• :'.;-%7 1:1 S-10-1 U 1, CRS 1973, a, amended. DISCRIMINATION AND AFFIRMATIVE ACTION 5. 'Ilie contractor agrees (I) comply with tilt' letter :lull %plrlt tit' the Ciri•rr:Itl:: as amenckd, and usher applicable law respecting discrimination and unfair em1)lo\nlertt 1?rac(itt. (' -1 �')!. t 19731, as amended), and as required by Executive Order. I:fluat Opportumity and Al'firinative .fiction. tl:;!;ti .ttl:r;I if). 1975. 1'lrrsuant thereto, the Pllosviitg prurisions \hull he vontuilied in all .`mle rr)ntrc:ch or iilil c'U:ttrt:c t,. During the performance of thi: contract, the contractor agrer, as foillows: (1) The contractor v.-ill not di.crirllinate a,-aill.t ;Ill\ emplovt'e or ;iplllic•ant ft,r e!illtit)1'Int•!lt hrr;:tl1t• ill race, creed, color. national origin, six, illarlt:il status, reli:;lfrll, :41ICeiti-v. tnunlal or physicall liandicap. fir aL't "tic comractor will lake affirmative action to insitre that :!pplicants :ire emp,tlived, mul that irlltll tt"rep :irt• treated during employment, without regard to the above lnentiolml Ch:lracteristic.. Sucil action ,Mali int:[ude. but not he limited to the following: employment. up,-ggrading. (lelllotion, or transfer, reerlti!:nrllt t,i recntitnent advertisings: lily-off:s or terminations: rites of pay or other form-, of compensation: and N,:Iui tion for training, including apprenticeship. Tile contractor agrees ill post in c•ollspic•uoux pim-e,, available it) employees and applicants for employment, notices to be provided by the contsactinu, officer scuin-, fur.it provisions of this non-discrimination clause: (2) "life contractor will, in all solicitations or advertiserieitts for employees placed by or on hell:ilf of the contractur, state that all dualified applicants will receive c•owidrration i•c►r employment \\itllout regard to) race, creed, color, national origin, sex, marital status. rclioioii, ance,,trv, :rental or physical lialidicap. or awe. (3) "Ilie contractor will send to each labor union or reprewntati%e of workers v.'ith \\[licit he Ilan co!Irctiye bargaining agreement or other contract or understanding„ notice to be provided by the contracting f>ftit e�. advising the labor union or workers' representative of the contractor's conlinittmem under tl:e Order, Equal Opportunity and Affirmative Action, dated April Ili, 1975. and of the r,lfc•s, r[',tl?:!tif+;!.. ; d relevant Orders of the Governor. (4) The contractor and labor unions will furnish all information an[I reports required by Exrcutive Order, Equal Opportunity and Affirmative Action of April 16, 1975, and by the niles, regulations and Orders of tht• Governor, or pursuant thereto, and will permit access to his books, records, and :tcemin(s by the contractin,, a0ency and the office of the Governor or his designee for purposes of investigation to ascertain compliancy with such niles, regulations and orders. (5) A labor organization will not Cxs:lude any individuA mlier\yise tltlalified From full memhersidl) rights ill such labor organization, or expel :tit\, such individual from membership in such labor or-:uiization or discriminate against a111' of Stti I11eInbL'rs In the full cn,joymc'nt of work opportunity, because of race, creed, color, sex, national origin, or ancestry. (6) A labor organization, or the employees or member. thereof will not aid. abet, incite, compel or coerce the cluing of any act defined ill this contract to be discriminatory or obstruct or prevent :ut\, person from complying with the provisions of this contract or any order issued thereunder: or attempt, either dir:cily or indirectly, to commit an\• :let defined in this contract to lie dlsc;illliwoorv. 395.53-01•C 028 lmlr ` .- __4.— of ___5_ pa(-cs .oils► E. M .01E. • 1 J 1 lit the event /► 11c contracl(,r \ -.13LISe\ 1)T till% c(inir. tll' t►t SllCll rules, TC'!�111a11(111s, ui' tlr(i�'T\. tl?2\ ."1::';':'t i`.:.:\ i`.' t':?11':l'l!t'li. 1'.'ri11111att'd ire \1!\�i�:lllell I11 \\hole or ill part and the contractt►r ina\ be dL'('I;!R'd I"k-II-''"!r ::lI-:l?cr til:i11n1rat, I% i:l atx4)T(Iall:e \\itlt procedures, authorized ill Exccrltivc Order. Vgtuil r)pt t'rtu:2i1\ .!!:(i ;f;irin:iti'.t :k,tI(►ij -tf \11111 16, ill--; an(! the rides, re'gulafton-,. ur order's pi'tlllllll,gated in :iic'i-kl:fll;'t' Ill. alit! he 1llyosed and r'--Illedlcs as illay be 111\(,IieE1 a\ III-m-i(it'(, I!l Order, l'. ,i!.11 t )I1pt3rllt!lltl :1111] •,ffirni:Itl\t' Action of April 16, 19"75, or by CIIIC\, It::!I1l;ll2(ti:\, (11' 1(2'ilt'2'\ !:2'11171fi1'r.11('(! :!! ;tt'l'(l-da!ice tllt'1'es%itll, t)r a\ otherwise provided by lam- (S) 'Ilic contracttir \01 indlide the pr(►\I\i(►rt\ (;I lt::i';21't':11)!7\ ( I ) tlirt3.t-h (`) Ill c%vr\' \uh-cmitract arld sub-con(ractor purcliase•order 1111le\\ e\eilil►ted b\ mile\, tvgtil:itinn\. (ir iii-del'\ i\•ut-d pur'\iiant ttl Fwcllti\t' Order. Equal Opportunity and affirtuatke Achim III April 10. 19-5. \o that Such llro\i'�i(►rls \\ill he hinding, tlpoll each sub -contractor or \endor. ']lie contractor \\ill 1;tkc \rich a(•lioit \\ith re\i,cct to :lit\' \uh-colitractinll 416" purchase order :is the contractl111-1 al!t'!tcV 111:1\• Elir't'ct. .1\ :1 211t':111\ (lf e11f1►1-cin!' \t►cll prt11'ision,�. includill'-p s:tllctolls for lion-contpll:ntC't'; pCo1'lllt,(f, 111,11 Ill tilt' t•'.('!'.i the c(►1111'at'T1,1' t VC0111cs itivrll\ed in. or is threatened with. litl"ation with tilt, st-dwiminim)r (,T t('l7t1!)i' :1� a rt'\illi t►f \Sit 1i (ill fiull ll\ llle t,U[Slractill!`, :I,,e1lC\', the l'E►tltrai'tO1' ilia\' 1t•tltiesi tilt.' Siatc of l ('It)I": tlo ;to t•wvr 111ttl sItch It�l'�alltll) 111 projt'lt tic interv,�[ of the State Elf Colorado, COLORADO LABOR PRE ERI.\CL 0. 1'ro\ i\ion\ of S-17-1 U 1 . A, ! U `, CRS 1973 I it prct: rcnc c .if (oltiraElo I:ilt()r .!rc al►plic allic to tlu% contract if public works within the Stale arc titideriaken hereunder itnll arc fiva:lct-d ill \tht►le or In part by Suite ftin(1\. (;1:NTRAL The laws of the State of Colorado :ml] rule, and i,,uct! pur,tiant thercii, \hall he applied in tilt, interpretation, execution and etifim-enlent ()f tlti\ cnnir:ici. An\' this contract \(herder or not ilx'or'poraled herein by reference which provides l'or arbitrali'in by an\- hodv or person or which is otherwise in conflict with said laws. rules 'hall he cI)IINI Icrcd gull and void. Nothing contained ill ;Ili\' pnwisl(►it incorporated herein I1\' I'O'cr('lIct' %%hich purp(irt\ 10 :R-2- c thiN fir ;tit\ (►tiler special pi-mi\i(211 ill whole or in part shall he valid or enforceable or availahle lit any ,;thin :It la\\' \\hetfler I►v way of cotllplaint, \ate defciiw OI olher\\ise. Any pro\i\ion rendered null mid \{sill !►v the operation of Ihi\ prml-'iorl Will not illvali(late ]Ili' remainder of this cut11racl to tilt' t'\ielil that the IN c:11'.011e of C\eclit',t►11. S. The \igiiatortes hereto aver that thcy are l*amiliar \\ ith I `,-N- 10I . el 1e11.. l bribery and Corrupt Infltic nce\) 'tilt] 1 S-8--1U 1, et \ey.. (Ahu\c (1l, Public Otfice ). (.1Z,S. 1(),.t, a, anlrncicd, and that no \ iolation of \rich prm iaio:is i\ present (i• fill' sitnatni-les a%cr that 14) (heir klltl\\Icil!u.c. 114) \tale t'Sllphi%ce has :111\ per\opal tir hellcllcla! !litcre\t \\ial\t►e\er in file service r►r prr►perty described herein 11 11iTNESS WHEREOF. the par!ies hereto have cxe.uted this A_rcenicnt on the day fii-\t above written. THE BOARD OF COUNTY COMMISSIONERS, STA I•: OF COLORADO EAGLE COUNT :11:1i. 1. +► tit ei . t.t ►`' F I :N O 1' R &4- Contrac(or_-- 1'�t=t t !!\'l. ItlE:l:('I(►i:. for the I")Ni 1 i t )11 ._.__ S1►t•ial Security Num11rr l)I': AR, I'MEA-1 O I: - -.-H EALTH ( E IN I tic II I t.k _.. Program Approval by: c /1/1-t _-__5 whi('11 is the 1a\1 of 5 page\ *Sew 111\Ittlt•i14111% rill W'.Vist' Nit1c. 395.53-02•CO35 .0 :x.,. :'r- S a.e:. !S' y ../k.. �•.., x, . • r�J C^� y-e.• •��i-=�.:i�.S-'�"- ..•a:{.•. y `••'LJa y� , '.•n-. .,..• _ •.� �!•:'•r ..t .L .''7{`` 'F .I'•}f" rn'r.• � • •S.w <f ..��`.1=1{d> q:[Aw a'L '•�ftti•Y�1'�•G-•''�•:.s L':�;�:Iti •• i.• ..i...� rs_�•fir: t.•^yn'i's • `'..i•• I: �y:.•� ri r :• ••. �.t �4 sNJi�+y.'C • /,'-'�,.•a : �. •�a J..�•3.�a4� \ :� 7f• ,._.!' cam% .;.'yi g71.'.a.•%'4t' •w5^. .�•i.. .�,}2'k �a.•:�.7. w�^'..�_ -'5;�.•�;�4:- .ice �-4. •r'i+'!',L:'•:-�• •' 1 4 _O ♦ a. � t . SI.. 2 P ^- ) ,. 4 ^..�` f Ih•^wT',.• [4 .:1:.Cr..=\ e 9 -ti 'S'!•e _ .• � yy'i3 �:1:• � •4J,'T•i�h es• ♦ s•• .� /=•: t,..t `��� f ti S :3 iJ I. I !'t :' r_ _ �.. ... - - .:.•'• 't ;X-Y.t.; is . r �«�%�: ��"t� >. y .J.�,1 � � i . �1- I- r - �. ..i 'y.: 'iK'�''••'Lw ..n+••!,i•• ""l• v a. . L r !•r �...1 P.:r t •�d.. + V•:. +P .�'• t e 'SS •:�1�. .. xi•.• ,ilM -.fJ .;11 i •J•iN �•.. k: M ma v �•s� . lr!1.S . .;�..'.: . �• `11, Yi. �'t!a � .�i1.>�rl}.1 I ���}•+;N:. �•� P • t�.'<:hi'> �•LM�I ti'i��� y .I 1 't s.' ! •�ti• !`' k Ff,-xJ'�t �. -•t �y ,L� �Y� Y 7 r' r d 1 }l!K R�.i• ll�[� ,( h { •yf 'L,..4 :ro4: x?.r:.. i� fir. I ! t. ! r••SAit �, .•.+v'•�',.%A, y/•�7.�: 1, r,'T �! r-T'ifT'i:'.. 1 "r t.LY,dv+a•:z7�y�'_lw.t1•.ti',.W"4t �v yy,. 1�rX: �'y.:,..,a ~. . It�t'2�'S�!i}<.' ~ th J tr �•,'S .y1. Srt°.7C(LY.pr - T' •. t 1 Attachment A E.P.S.D.T. BUDGET Eagle County July 1 , 1981 to June 30, 1982 Case Managers . . . . . . . . . . . . . . . . . . . . . 3,046.00 Fringe Benefits . . . . . . . . . . . . . . . . . . . . $ 202.00 Administrative Cost . . . . . . . . . . . . . . . . . . $ 300.00 Travel. . . . . . . . . . . . . . . . . . . . . . . . . $ Date 5-1-81 250.00 Total $ 3,798.00