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HomeMy WebLinkAboutR12-099 Soy Sano Project Commissioner J - Oithoved adoption of the following resolution:
BOARD OF COUNTY COMMISSIONERS
COUNTY OF EAGLE, STATE OF COLORADO O
RESOLUTION NO. 2012- 0 t y `
RESOLUTION RATIFYING APPROVED TASK ORDER CONTRACT - WAIVER #154
BETWEEN THE STATE OF COLORADO AND EAGLE COUNTY, COLORADO FOR
DEVELOPMENT OF THE SOY SANO PROJECT
WHEREAS, the Board of County Commissioners of Eagle County, Colorado ("Board")
approved a Master Contract with the State of Colorado dated January 17, 2012 with routing
number 13 FAA 00016; and
WHEREAS, the State of Colorado has approved an amendment to the Master Contract
in the form of Task Order Contract- Waiver #154, Routing No. 13 FAA 48409, that grants
$141,828 to County to develop the Soy Sano Project which aims to reduce health disparities
and decrease cardiovascular disease by promoting nutrition, providing access to healthy food
and reducing obesity risk factors, and requires immediate signature by Eagle County; and
WHEREAS, the Board desires to ratify and approve Task Order Contract- Waiver
#154, Routing No. 13 FAA 48409, between the State of Colorado and Eagle County, Colorado.
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF
COUNTY COMMISSIONERS OF THE COUNTY OF EAGLE, STATE OF
COLORADO:
THAT, the Board hereby approves and ratifies Task Order Contract - Waiver #154,
Routing No. 13 FAA 48409, between the State of Colorado and Eagle County, Colorado in the
form attached as Exhibit A.
THAT, the Board of County Commissioners finds, determines and declares that this
Resolution is necessary for the public health, safety and welfare of the citizens of the County of
Eagle, State of Colorado.
MOVED, READ AND ADOPTED by the Board of County Commissioners of the
County of Eagle, State of Colorado, at its regular meeting held this lb day of f1,, 2012.
COUNTY OF EAGLE, STATE OF
COLORADO, By and Through Its
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y c4, G
OARD OF COUNTY COMMISSIONERS
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ATTEST: • s ;; �
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risk.. _ _., .,: .•s..t 4 ''' ' 'orb ; 147 : l.
Cler o the Bo. r of Peter F. Runyon /
County Commissioners C - .
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Num
Jon -y
Co :loner
--il—Q4.44-
Sara J. Fisher
l Commissioner
Commissioner " I14 -- seconded adoption of the foregoing resolution. The roll
having been called, the vote was as follows:
Commissioner Runyon
Commissioner Stavney I�--4 k
Commissioner Fisher �, w
This resolution passed by /6 vote of the Board of County Commissioners of
the County of Eagle, State of Colorado.
DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT
ROUTING NO. 13 FAA 48409
APPROVED TASK ORDER CONTRACT — WAIVER #154
This Task Order Contract is issued pursuant to Master Contract made on 01/17/2012, with routing number 13 FAA 00016
STATE: CONTRACTOR
State of Colorado for the use & benefit of the Board of County Commissioners of Eagle
Department of Public Health and County (a political subdivision of the state of
Environment Colorado)
Office of Health Disparities 500 Broadway
4300 Cherry Creek Drive South Eagle, Colorado 81631 -0850
Denver, Colorado 80246 for the use and benefit of the
Eagle County Public Health Agency
551 Broadway
Eagle, Colorado 81631
TASK ORDER MADE DATE: CONTRACTOR ENTITY TYPE:
8/31/2012 Colorado Political Subdivision
PO /SC ENCUMBRANCE NUMBER:
PO FAA ADM1348409
TERM: BILLING STATEMENTS RECEIVED:
This Task Order shall be effective upon Monthly
approval by the State Controller, or designee,
or on 10/01/201Z whichever is later. The STATUTORY AUTHORITY:
Task Order shall end on 06/30/2013. C.R.S. 25-4-2203
PRICE STRUCTURE: CONTRACT PRICE NOT TO EXCEED:
Cost Reimbursement $141,828
PROCUREMENT METHOD: FEDERAL FUNDING DOLLARS: $f
Exempt STATE FUNDING DOLLARS $141,828
BID /RFP /LIST PRICE AGREEMENT NUMBER: MAXIMUM AMOUNT AVAILABLE PER FISCAL YEAR:
Not Applicable FY 13: $141,828
LAW SPECIFIED VENDOR STATUTE:
Not Applicable
STATE REPRESENTATIVE: CONTRACTOR REPRESENTATIVE:
Kathy Jacobsen Jennifer Ludwig
Department of Public Health and Environment Eagle County Public Health
PSD- FSU -A5 P. O. Box 660
4300 Cherry Creek Drive South Eagle, Colorado 81631 -0660
Denver, CO 80246
SCOPE OF WORK:
Develop the iSoy Sano! Project to promote nutrition, provide access to healthy food, and reduce
obesity risk factors all for the purpose of decreasing cardiovascular disease.
Page 1 of 6 Rev 6/25/09
EXHIBrrs:
The following exhibits are hereby incorporated:
Exhibit A - Additional Provisions (and its attachments if any — e.g., A -1, A -2, etc.)
Exhibit B - Statement of Work (and its attachments if any — e.g., B -1, B -2, etc.)
Exhibit C - Budget (and its attachments if any — e.g., C -1, C -2, etc.)
Exhibit D Grant Funding Change Letter Sample
GENERAL PROVISIONS
The following clauses apply to this Task Order Contract. These general clauses may have been expanded upon or made
more specific in some instances in exhibits to this Task Order Contract. To the extent that other provisions of this Task
Order Contract provide more specificity than these general clauses, the more specific provision shall control.
1. This Task Order Contract is being entered into pursuant to the terms and conditions of the Master Contract
including, but not limited to, Exhibit One thereto. The total term of this Task Order Contract, including
any renewals or extensions, may not exceed five (5) years. The parties intend and agree that all work shall
be performed according to the standards, terms and conditions set forth in the Master Contract.
2. In accordance with section 24 -30- 202(1), C.R.S., as amended, this Task Order Contract is not valid until it
has been approved by the State Controller, or an authorized delegee thereof. The Contractor is not
authorized to, and shall not; commence performance under this Task Order Contract until this Task Order
Contract has been approved by the State Controller or delegee. The State shall have no financial obligation
to the Contractor whatsoever for any work or services or, any costs or expenses, incurred by the Contractor
prior to the effective date of this Task Order Contract. If the State Controller approves this Task Order
Contract on or before its proposed effective date, then the Contractor shall commence performance under
this Task Order Contract on the proposed effective date. If the State Controller approves this Task Order
Contract after its proposed effective date, then the Contractor shall only commence performance under this
Task Order Contract on that later date. The initial term of this Task Order Contract shall continue through
and including the date specified on page one of this Task Order Contract, unless sooner terminated by the
parties pursuant to the terms and conditions of this Task Order Contract and/or the Master Contract.
Contractor's commencement of performance under this Task Order Contract shall be deemed acceptance of
the terms and conditions of this Task Order Contract.
3. The Master Contract and its exhibits and/or attachments are incorporated herein by this reference and made
a part hereof as if fully set forth herein. Unless otherwise stated, all exhibits and/or attachments to this Task
Order Contract are incorporated herein and made a part of this Task Order Contract. Unless otherwise stated,
the terms of this Task Order Contract shall control over any conflicting terms in any of its exhibits. In the event
of conflicts or inconsistencies between the Master Contract and this Task Order Contract (including its exhibits
and/or attachments), or between this Task Order Contract and its exhibits and/or attachments, such conflicts or
inconsistencies shall be resolved by reference to the documents in the following order of priority: 1) the
Page 2 of 6 Rev 6/25/09
Special Provisions of the Master Contract; 2) the Master Contract (other than the Special Provisions) and its
exhibits and attachments in the order specified in the Master Contract; 3) this Task Order Contract; 4) the
Additional Provisions -_Exhibit A, and its attachments if included, to this Task Order Contract; 5) the
Scope /Statement of Work - Exhibit B, and its attachments if included, to this Task Order Contract; 6) other
exhibits /attachments to this Task Order Contract in their order of appearance.
4. The Contractor, in accordance with the terms and conditions of the Master Contract and this Task Order
Contract, shall perform and complete, in a timely and satisfactory manner, all work items described in the
Statement of Work and Budget, which are incorporated herein by this reference, made a part hereof and
attached hereto as "Exhibit B" and "Exhibit C ".
5. The State, with the concurrence of the Contractor, may, among other things, prospectively renew or extend
the term of this Task Order Contract, subject to the limitations set forth in the Master Contract, increase or
decrease the amount payable under this Task Order Contract, or add to, delete from, and/or modify this
Task Order Contract's Statement of Work through a contract amendment. To be effective, the amendment
must be signed by the State and the Contractor, and be approved by the State Controller or an authorized
delegate thereof. This contract is subject to such modifications as may be required by changes in Federal
or State law, or their implementing regulations. Any such required modification shall automatically be
incorporated into and be part of this Task Order Contract on the effective date of such change as if fully set
forth herein.
6. The conditions, provisions, and terms of any RFP attached hereto, if applicable, establish the minimum
standards of performance that the Contractor must meet under this Task Order Contract. If the Contractor's
Proposal, if attached hereto, or any attachments or exhibits thereto, or the Scope /Statement of Work -
Exhibit B, establishes or creates standards of performance greater than those set forth in the RFP, then the
Contractor shall also meet those standards of performance under this Task Order Contract.
7. STATEWIDE CONTRACT MANAGEMENT SYSTEM [This section shall apply when the Effective
Date is on or after July 1, 2009 and the maximum amount payable to Contractor hereunder is $100,000 or
higher]
By entering into this Task Order Contract, Contractor agrees to be governed, and to abide, by the
provisions of CRS §24 -102 - 205, §24- 102 -206, §24 -103 -601, §24- 103.5 -101 and §24- 105 -102 concerning
the monitoring of vendor performance on state contracts and inclusion of contract performance information
in a statewide contract management system.
Contractor's performance shall be evaluated in accordance with the terms and conditions of this Task Order
Contract, State law, including CRS §24- 103.5 -101, and State Fiscal Rules, Policies and Guidance.
Evaluation of Contractor's performance shall be part of the normal contract administration process and
Contractor's performance will be systematically recorded in the statewide Contract Management System.
Areas of review shall include, but shall not be limited to quality, cost and timeliness. Collection of
information relevant to the performance of Contractor's obligations under this Task Order Contract shall be
determined by the specific requirements of such obligations and shall include factors tailored to match the
requirements of the Statement of Project of this Task Order Contract. Such performance information shall
be entered into the statewide Contract Management System at intervals established in the Statement of
Project and a final review and rating shall be rendered within 30 days of the end of the Task Order Contract
term. Contractor shall be notified following each performance and shall address or correct any identified
problem in a timely manner and maintain work progress.
Should the final performance evaluation determine that Contractor demonstrated a gross failure to meet the
performance measures established under the Statement of Project, the Executive Director of the Colorado
Department of Personnel and Administration (Executive Director), upon request by the Colorado
Department of Public Health and Environment and showing of good cause, may debar Contractor and
Page 3 of 6 Rev 6/25/09
prohibit Contractor from bidding on future contracts. Contractor may contest the final evaluation and result
by: (i) filing rebuttal statements, which may result in either removal or correction of the evaluation (CRS
§24 -105- 102(6)), or (ii) under CRS §24 -105- 102(6), exercising the debarment protest and appeal rights
provided in CRS § §24- 109 -106, 107, 201 or 202, which may result in the reversal of the debarment and
reinstatement of Contractor, by the Executive Director, upon showing of good cause.
8. If this Contract involves federal funds or compliance is otherwise federally mandated, the Contractor and
its agent(s) shall at all times during the term of this contract strictly adhere to all applicable federal laws,
state laws, Executive Orders and implementing regulations as they currently exist and may hereafter be
amended. Without limitation, these federal laws and regulations include the Federal Funding
Accountability and Transparency Act of 2006 (Public Law 109 -282), as amended by §6062 of Public Law
110 -252, including without limitation all data reporting requirements required there under. This Act is also
referred to as FFATA.
Page 4 of 6 Rev 6/25/09
TIIE PARTIES HERETO HAVE EXECUTED THIS CONTRACT
* Persons signing for Contractor hereby swear and affirm that they are authorized to act on Contractor's
behalf and acknowledge that the State is relying on their representations to that effect.
CONTRACTOR: STATE OF COLORADO:
BOARD OF COUNTY COMMISSIONERS OF John W. Hickenlooper, GOVERNOR
EAGLE COUNTY (a political subdivision of the
state of Colorado) for the use and benefit of
EAGLE COUNTY PUBLIC HEALTH AGENCY
Legal Name of Contracting Entity
By
For Executive Director
Department of Public Health and Environment
Signature of Authorized Officer
Print Name of Authorized Officer
Department Program Approval:
By
Print Title of Authorized Officer
ALL CONTRACTS MUST BE APPROVED BY THE STATE CONTROLLER
CRS §24-30-202 requires the State Controller to approve all State Contracts. This Contract is not valid until
signed and dated below by the State Controller or delegate. Contractor is not authorized to begin performance until
such time. If Contractor begins performing prior thereto, the State of Colorado is not obligated to pay Contractor
for such performance or for any goods and/or services provided hereunder.
STATE CONTROLLER:
David J. McDermott, CPA
By
Date
Page 5 of 6 Rev 6/25/09
•
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Page 6 of 6 Rev 6/25/09
EXHIBIT A
ADDITIONAL PROVISIONS
To Task Order Contract Dated 08/31/2012- Contract Routing Number 13 FAA 48411
These provisions are to be read and interpreted in conjunction with the provisions of the Task Order
Contract specified above.
1. The list of acronyms attached hereto as Attachment A -1 may be referenced to in Exhibit A, Exhibit B,
and all and any attachments thereof in this Task Order Contract.
2. This Task Order Contract contains state funds.
3. To receive compensation under this Task Order Contract, the Contractor shall submit a signed monthly,
CDPHE Reimbursement Invoice Form. This form is accessible from the CDPHE internet website
http: / /www.cdphe. state. co. us /Standardizedlnvoice /index.html. CDPHE will provide technical assistance in
accessing and completing the form. The CDPHE Reimbursement Invoice Form must be submitted within
sixty (60) calendar days of the end of the billing period for which services were rendered. Expenditures
shall be in accordance with the Statement of Work attached hereto as Exhibit B and incorporated herein
and the associated Budget attached hereto as Exhibit C and incorporated herein. All expenditures must be
reasonable and necessary for the performance of this Contract, and must comply with The State of
Colorado, specifically the Colorado Department of Public Health and Environment, fiscal guidelines and
rules. Costs associated with curricula and new cessation program/model development, individual cessation
aides and nicotine replacement therapy, subscriptions and professional organization membership fees and
dues, cell phone acquisition and monthly costs, out of state travel, rent, capital projects, equipment and
maintenance shall not be reimbursed without prior written consent of the State.
Submit completed CDPHE Reimbursement Invoice Form to:
Colorado Department of Public Health and Environment
Accounting/Grants Unit
PSD- OHD -A5
4300 Cherry Creek Drive South
Denver, CO 80246
To be considered for payment, billings for payments pursuant to this Task Order Contract must be received
within a reasonable time after the period for which payment is requested, but in no event no later than sixty
(60) calendar days after the relevant performance period has passed. Final billings under this Task Order
Contract must be received by the State within a reasonable time after the expiration or termination of this
Task Order Contract; but in no event no later than sixty (60) calendar days from the effective expiration or
termination date of this Task Order Contract.
Unless otherwise provided for in this Task Order Contract, "Local Match ", if any, shall be included on all
invoices as required by funding source.
4. Time Limit For Acceptance Of Deliverables.
a. Evaluation Period. The State shall have thirty (30) calendar days from the date a deliverable is
delivered to the State by the Contractor to evaluate that deliverable, except for those deliverables
that have a different time negotiated by the State and the Contractor.
b. Notice of Defect. If the State believes in good faith that a deliverable fails to meet the design
specifications for that particular deliverable, or is otherwise deficient, then the State shall notify
the Contractor of the failure or deficiencies, in writing, within thirty (30) calendar days of: 1) the
date the deliverable is delivered to the State by the Contractor if the State is aware of the failure or
To be attached to CDPHE Page 1 of 3 Revised: 12/19/06
Task Order v1.0 (3/12) contract template
EXHIBIT A
deficiency at the time of delivery; or 2) the date the State becomes aware of the failure or
deficiency. The above time frame shall apply to all deliverables except for those deliverables that
have a different time negotiated by the State and the Contractor in writing pursuant to the State's
fiscal rules.
c. Time to Correct Defect. Upon receipt of timely written notice of an objection to a completed
deliverable, the Contractor shall have a reasonable period of time, not to exceed ten (10) calendar
days, to correct the noted deficiencies. If the Contractor fails to correct such deficiencies within
ten (10) calendar days, the Contractor shall be in default of its obligations under this Task Order
Contract and the State, at its option, may elect to terminate this Task Order Contract or the Master
Contract and all Task Order Contracts entered into pursuant to the Master Contract.
5. Health Insurance Portability and Accountability Act (HIPAA) Business Associate Determination.
The State has determined that this Task Order Contract does not constitute a Business Associate
relationship under HIPAA.
6. Contractor must notify the State within thirty (30) days of a change of the Project Director or Principal
Investigator responsible for the performance of services provided under this Task Order Contract.
7. Contractor shall request prior approval in writing from the State for all modifications to the Statement of
Work/Work Plan or for any modification to direct costs in excess of ten percent (10 %) of the total budget
for direct costs. Any request for a modification to the Budget in excess of ten percent (10 %) of the total
budget for direct costs shall be submitted to the State by February 28, 2013 and may require an amendment
in accordance with Section 5 of this Task Order Contract. Requests for modifications to the Statement of
Work/Work Plan may require an amendment regardless of dollar amount.
8. Contractor shall participate in state -level evaluation efforts as requested by the State including, but not
limited to, progress reports on the implementation and accomplishments of the approved Work Plan in a
format provided by the State. Progress reports shall be due fifteen (15) days after each calendar quarter.
Calendar quarters shall be July 1 through September 30, October 1 through December 31, January 1
through March 31, and April 1 through June 30, as applicable.
Failure to submit progress reports in accordance with the above time frames may result in a delay or denial
of the reimbursement request for those periods.
9. Notwithstanding the terms contained in General Provisions of the Master Contract, Section 9, Rights in
Data, Documents and Computer Software or Other Intellectual Property, unless otherwise provided for, all
data collected or produced or derived exclusively from the Contractor's or subcontractor's work under this
Task Order Contract shall remain the sole property of the State, whether in individual, aggregate, identified
or de- identified form or any other form required by the State. To facilitate follow -up, research, surveillance
and evaluation, any such data collected, used or acquired shall be made available in any form required by
the State, to the State and any other entity designated by the State.
Any such data collected, used or acquired shall be used solely for the purposes of this Task Order Contract.
The Contractor and its subcontractors agree not to release, divulge, publish, transfer, sell, or otherwise
make known any such data to unauthorized persons without the express prior written consent of the State or
as otherwise required by law. This includes a prior written request by the Contractor to the State for
submission of abstracts or reports to conferences, which utilize data collected under this Task Order
Contract.
Notwithstanding the foregoing, the Contractor shall be entitled to retain a set of any such data collected or
work papers necessary to perform its duties under this Task Order Contract and in accordance with
professional standards.
10. Notwithstanding the terms contained in General Provisions of the Master Contract, Section 9, Rights in
Data, Documents and Computer Software or Other Intellectual Property, or Section 23.i, General
To be . .ched to CDPHE Page 2 of 3 Revised: 12/19/06
Task • • er v1.0 (3/12) contract template
EXHIBIT A
Provisions, Media or Public Announcements, the State of Colorado, specifically the Department of Public
Health and Environment, shall be the owner of all printed materials, graphic representations, educational
materials, audio - visual products, or any other media, in whatever form, created under this Task Order
Contract. This requirement applies, but is not limited to, any brochure, flyer, presentation, billboard, radio
spot, website, banner advertisement. The State reserves the right to require logos, or other wording on any
material, representation, product or other media form created under this Task Order Contract.
Any material, representation, product or other media form that will use the State's or logo or information
must be approved by the State prior to production and distribution. A minimum of ten (10) business days is
required for the review and approval process.
11. Notwithstanding the terms contained in the General Provisions of the Master Contract, Section 25,
Conformance with Law, the Contractor shall comply with the provisions of Section 601 of Title VI of the
Civil Rights Act of 1964, as amended, which states that "no person in the United States shall on the
grounds of race, color or national origin, be excluded from participation in, be denied the benefits of, or be
subjected to discrimination under any program actively receiving Federal financial assistance." The Office
for Civil Rights has established that it is the responsibility of any program that is a recipient of federal
funds to ensure that any Limited English Proficient (LEP) person or beneficiary have meaningful access to
programs, services and information. The Contractor and contract personnel shall adopt and implement
policies and procedures in which reasonable steps are taken to provide language assistance in order to
ensure equal access to LEP persons or beneficiaries. The Contractor and contract personnel shall advise
LEP individuals that language assistance will be provided at no cost to the LEP person or beneficiary.
12. The Contractor affirms that it maintains no affiliations or contractual relationships, direct or indirect, with
tobacco companies, owners, affiliate, subsidiaries, holding companies or companies involved in any way in
the production, processing, distribution, promotion, sales, or use of tobacco.
13. Notwithstanding anything in this Task Order to the contrary, the parties understand and agree that all terms
and conditions of this Task Order which may require continued performance, compliance, or effect beyond
the termination date of this Task Order and shall survive such termination date and shall be enforceable by
the State as provided herein in the event of failure to perform or comply by the Contractor.
14. The State of Colorado, specifically the Colorado Department of Public Health and Environment, shall be
the owner of all equipment as defined by Federal Accounting Standards Advisory Board (FASAB)
Generally Accepted Accounting Principles (GAAP) purchased under this Task Order Contract. At the end
of the term of this Task Order Contract, the State shall approve the disposition of all equipment.
15. The Contractor shall not use funds provided under this Task Order Contract for the purpose of lobbying as
defined in Colorado Revised Statutes (C.R. S.) 24- 6- 301(3.5)(a).
16. In accordance with paragraph 5 of the General Provisions, this contract can be modified as a result of an
increase or decrease in the grant award. Such modification can be accomplished using the Grant Funding
Change Letter, attached and reference herein as Exhibit D.
To be attached to CDPHE Page 3 of 3 Revised: 12 /19/06
Task Order v1.0 (3/12) contract template
Attachment A -1
Commonly Used Acronyms and Abbreviations That May Be Referenced In the Scope of Work:
ACS American Cancer Society
ACNS Alamosa County Nursing Service
ACF Administration for Children and Families
ADA Americans with Disabilities Act
ADAD Alcohol and Drug Abuse Division
AHA American Heart Association
AIDS Acquired Immune Deficiency Syndrome
ALA American Lung Association
ALA(C) American Lung Association (of Colorado)
AMCHP Association of Matemal Child Health Programs
ANR Americans for Non - Smokers' Rights
ARC Addiction Recovery Centers
ARRA American Recovery and Reinvestment Act
ASC Adams State College
ASSIST American Stop Smoking Intervention Study
ASTHO Association of State and Territorial Health Office
B &G Boys & Girls
BACCHUS BACCHUS Peer Education Network
BAG Build a Generation
BBLHC Boulder Broomfield Latino Health Coalition
BC Boulder County
BCCP Breast and Cervical Cancer Program
BCHD Bent County Health Dept
BCPH Boulder County Public Health
BCPHA Baca County Public Health Agency
BCDSS Baca County Dept Social Services
BCTEPP Bent County Tobacco Education Prevention Partnership
BGC Boys & Girls Club
BGCMD Boys & Girls of Metro Denver
BHS Broomfield High School
BMTF Baby & Me Tobacco Free
BOCES Board of Cooperative Educational Services
BOH Board of Health
BRFSS Behavioral Risk Factor Surveillance System
BVBAG Buena Vista Build a Generation
BVSD Boulder Valley School District
Bx Biopsy
C Choice
CAD Coronary Artery Disease
CASB Colorado Association of School Board
CB Community -based System
CBE Clinical Breast Exam
CBO Community -based Organization
CC Clear Creek
CC Custer County
CC Community Coordination/Coordinator
CCAP Larimer County Child Care Assistance Program
CCC Colorado Cancer Coalition
CCCHE Colorado Community Coalition for health Equity
CCGC Colorado Clinical Guidelines Collaborative
CCIAA Colorado Clean Indoor Air Act
CCMC Colorado Clinical Managed Care Network
CCMC Commission for Case Manager Certification
CCPD Cancer, Cardiovascular, and Pulmonary Disease
Page 1 of 6
Attachment A -1
CCTCI Colorado Chew Tobacco Collaborative Initiative
CCTEPP Custer County Tobacco Education Prevention Partnership
CDC Centers for Disease Control and Prevention
CDE Colorado Department of Education
CDPHE Colorado Department of Public Health and Environment
CDU Chronic Disease Unit
CEC Career Education Center
CEO Chief Executive Officer
CFDA Catalog of Federal Domestic Assistance
CFFC Colorado Foundation for Families and Children
CFPI Colorado Family Planning Initiative
CHIN Community Health Information Network
CICP Colorado Indigent Care Program
CJD Colorado Judicial Department
CM Case Management
CMC Colorado Mountain College
CMS Contract Management System
CMS Creative Media Solutions
CNCC Colorado Northwestern Community College
CNS County Nursing Service
CO Colorado
COD Colorado Donated Dental Services Program
COPAN Colorado Physical Activity and Nutrition Program
COV Colorado Van Program
CPCF Colorado Parent and Child Foundation
CPHA Colorado Public Health Association
CPT Current Procedural Technology
CRCCP Colorectal Cancer Screening Program
CRUE Culturally Responsive Urban Education
CSAP Colorado Student Assessment Program
CSH Coordinated School Health
CSU Colorado State University
CSU -P Colorado State University- Pueblo's
CTC Connect to Care
CTEPA Colorado Tobacco Education and Prevention Alliance
CTFK Campaign for Tobacco -Free Kids
CTRP Colorado Tobacco Research Program
CTP Crossroads Turning Point
CU University of Colorado, Boulder
CWCCI Colorado Women's Cancer Control Initiative
CY Contract Year
DAISI Denver At -home Intervention Service Initiative
DASH Division of Adolescent & School Health (CDC)
DCMH Delta County Memorial Hospital
DH Denver Health
DHHA Denver Health and Hospital Authority
DHS Department of Human Services
DHHS Unites States Department of Health and Human Services
DOR Department of Revenue
DOS Delta Opportunity School
DSS Department of Social Services
E &I Education and Information
EAP Employee Assistance Program
EBHV Evidence -Based Home Visiting to Prevent Child Maltreatment Grant Program
ECC Early childhood council
ECC Electrocardiogram
ECCLC Early Childhood Council of Larimer County
ECLC Early Childhood Leadership Council/Commission
Page 2 of 6
Attachment A -1
E.D. Executive Director
EHS Early Head Start
EMR Electronic Medical Record
EMT Emergency Medical Technicians
EPA Environmental Protection Agency
EPE Epidemiology Planning and Evaluation
ESL English as a Second Language
ETS Environmental Tobacco Smoke (a.k.a. secondhand smoke)
FIRC Family and Intercultural Resource Center
FICA The Federal Insurance Contribution Act
FDA Food and Drug Administration
FNA Final Needle Aspiration
FPP Family Planning Program
FPL Federal Poverty Level
FRCC Front Range Community College
FTE Full Time Equivalent
FTP File Transfer Protocol
FY Fiscal Year
FYI Family Youth Initiatives
GASO Great American Smoke -out
GED General Education Development
GASP CO Group to Alleviate Smoking Pollution of Colorado
Get R!EAL (GR) Resist! Expose Advertising Lies (Youth Empowerment Program)
GLBT Gay, Lesbian, Bisexual, and Transgender
GYN Gynecological
HCP Health Care Program For Children with Special Needs
HCYS Huerfano County Youth Services
HHS Health and Human Services
HIPPA Health Insurance Portability and Accountability Act of 1996
HIPPY Home Instruction for Parents of Preschool Youngster
HIT Health Improvement Team
HIV Human Immunodeficiency Virus
HPV Human Papillomamavirus
HR Human Resources
hr hour
HRSA Health Resources and Services Administration
HSL High School Leadership
ID Identification
IIK Invest in Kids
ISHT Interagency School Health Team
IT Information Technology
JAC Juvenile Assessment Center
KIS Keeping in STEPP
KMH Keefe Memorial Hospital
KPC Kevin Patrick Caleum
LAHCDHD Las Animas Huerfano Counties District Health Department
LBW Low Birth Weight
LC Learning Community
LGBT Lesbian, Gay, Bisexual, Transgender
LEM Latinas en Movimiento
LHA Local Health Agency
LHD Local Health Department
LLC Limited Liability Company
LRCC Latino Regional Community Coalition
LRPC Latino a Research and Policy Center
LST Life Skills Training
LSTPEN Latino Statewide Tobacco Prevention and Education Netw
LWB Live Well Broomfield
Page 3 of 6
Attachment A -1
MCHA Montezuma Housing Authority
MCHD Montezuma County Health Department
MCHS Montezuma -Cortez High School
MCPN Metro Community Provider Network
MCRC Media Campaign Resource Center — CDC
MD Medical Doctor
MHCBBC Mental Health Center Serving Boulder and Broomfield Counties
MIECHV Maternal, Infant and Early Childhood Home Visiting Program
MO Month
MOB Medical Office Building
MOU Memorandum of Understanding
MPA Master of Public Administration in Health and Human Services
MPH Master of Public Health
MRI Magnetic Resonance Imaging Scan
MS Master of Science
MSA Master Settlement Agreement
MUH Multi -user Housing
MYAT Multi- Disciplinary Youth Assessment Team
N/A Not Applicable
NACCHO National Association of County and City Health Officials
NACR Native American Cancer Research
NAQC North American Quitline Consortium
NASBE National Association of State Board of Education
NCHD Northeast Colorado Health Department
NCI National Cancer Institute
NE North East
NFP Nurse- Family Partnership
NFPNSO Nurse - Family Partnership National Service Office
NHVP Nurse Home Visitor Program
NIDA National Institute on Drug Abuse
NIH National Institute of Health
NJH National Jewish Medical and Research Center
N -O -T Not -on- Tobacco, (ALA's Youth Smoking Cessation Program)
NP Nurse Practitioner
NPP Nurturing Parenting Program
NRT Nicotine Replacement Therapy
NSBA National School Boards Association
OSH Office on Smoking or Health (CDC)
OTC Over the Counter
PA Physician's Assistant
PAC Prevention Awareness Crew
PACT Partners Assessing Chew Tobacco
PAT Parents as Teachers
PCCHD Pueblo City- County Health Department
PPC Personal Care Providers
PE Presumptive Eligibility
PEN Parent Engagement Network
PVCHC Peak Vista Community Health Center
PHN Public Health Nurse
PIO Public Information Officer
PM Peer Mentor
PMC Parkview Medical Center
PMR Planning Management Region
PN Patient Navigator
PO Purchase Order
PPC Policy Partner Committee
PPFC Pikes Peak Family Connections
PPN Prevention Policy Network
Page 4 of 6
Attachment A -1
PRA Policy Resource Alliance
PRAMS Pregnancy Risk Assessment and Monitoring Survey
PRIDE Pure Respect Initiative Direct Education
PSA Public Service Announcement
PSD Prevention Service Division
PTEPP Pueblo Tobacco Education and Prevention Partnership
PVC Prairie View Clinic
Q1 Quarter One
Q2 Quarter Two
Q3 Quarter Three
Q4 Quarter Four
QI Quality Improvement
QOL Quality of Life
RDAC Regional Disparities Advisory Council
RFA Request for Applications
RFP Request For Proposals
RIE Reach, Implementation and Effectiveness
RIHEL Regional Institute for Health and Environment
RMC Rocky Mountain Center for Health Promotion & Education
RMRH Rocky Mountain Rural Health
RMYC Rocky Mountain Youth Corps
RN Registered Nurse
Rx Prescription
RY Reconnecting Youth
SafeCare
SAMHSA Substance Abuse Mental Health Services Administration
SB School -based System
SBAG Salida Build A Generation
SBHC School -Based Health Centers
SCYC School Community Youth Coalition
SCRHC Southern Colorado Regional Health Collaborative
SD Service Delivery
SECH Southeast Colorado Hospital
SEMHS Southeast Mental Health Services
SES Socio- Economic Status
SEW School Employee Wellness
SGR Surgeon General's Report
SHAC Smoke -free Housing Action Committee
SHI School Health Index
SHS Secondhand Smoke
SIDS Sudden Infant Death Syndrome
SLV San Luis Valley
SMART Staying Motivated at Reducing Temptations
SMART OUTCOME OBJECTIVE Specific, Measurable, Achievable, Realistic, Time -Bound
SMSU Self Management Service Unit
SRO School Resource Officer
STD Sexually Transmitted Disease
STEPP State Tobacco Education and Prevention Partnership
STW Straight -to -Work
SVVSD St. Vrain Valley School District
SWOT Strengths, Weaknesses, Opportunities, Threats
SYNAR Synar Regulation
TA Technical Assistance
TABS Tobacco Attitudes and Behavior Survey
TAG Technical Advisory Group (for evaluation & TPEG)
TANF Temporary Aid to Needy Families
TARP Tobacco Advocacy and Resource Partnership
TBD To Be Determine
Page 5 of 6
Attachment A -1
TCP Tobacco Control Partners
TDAC Tobacco Disparities Advisory Council
TDG Tobacco Disparities Grant
TDS Tobacco Disparities Subcommittee
TEACH Teaching Equity to Advance Community Health
TEFAP The Emergency Food Assistance Program
TEPCGP Tobacco Education Prevention and Cessation Grant Program
TEPP Tobacco Education Prevention Partnership
TFCCI Tobacco -Free Colorado Communities Initiative
TFLC Tobacco Free Larimer County
TFS Tobacco -Free Schools
TFS Law Tobacco -Free Schools Law
TGYS Tony Grampsas Youth Services
Title V Title V of the Social Security Act
TND Project Toward No Drug Abuse
TPEG Tobacco Program Evaluation Group
TPI Tobacco Prevention Initiative
TRC Tobacco Education and Prevention and Cessation Program Review Committee
TRI Tobacco Rapid Improvement Activity
TRIA Tobacco Rapid Improvement Assessment
TTI Tony Grampsas Tobacco Initiative
UCD University of Colorado — Denver
UCDHSC Health Sciences Center at UCD (sometimes abr. UCHSC)
UCDHSC University of Colorado at Denver and Health Sciences Center
US United States of America
USSTC US Smokeless Tobacco Company
VP Vice President
Well COA Wellness Councils of America
WHU Women's Health Unit
WIC Women, Infants, Children
WWC Women's Wellness Connection
Y @C Youth at Crossroads
YE Youth Empowerment
YPH Youth Partnership for Health
Yr Year
YRBS Youth Risk Behavior Survey
YSAP Youth Substance Abuse Prevention Coalition
YTS Youth Tobacco Survey
YVMC Yampa Valley Medical Center
5 A's Ask, Advise, Assess, Assist, Arrange
2A's R Ask, Advise, Refer
Page 6of6
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EXHIBIT D
GRANT FUNDING CHANGE LETTER
1 Date: 1 State Fiscal Year: 1 Grant Funding Change Letter # 1 CMS Routing #
TO: Insert Grantee's name
In accordance with Section of the Original Contract routing number , [insert the following
language here if previous amendment(s), renewal(s) have been processed] as amended by [include all
previous amendment(s), renewal(s) and their routing numbers], [insert the following word here if
previous amendment(s), renewal(s) have been processed] between the State of Colorado, Department
of Public Health and Environment and Contractor's Name beginning Insert start date <insert start date of
original contract> and ending on Insert ending date <insert ending date of current contract amendment >,
the undersigned commits the following funds to the Grant:
The amount of grant funds available and specified in Section of <insert contract amendment
number and routing number> is ❑ increased or ❑ decreased by $amount of change to a new total
funds available of $ < insert new cumulative total> for the following reason: . Section
is hereby modified accordingly.
This Grant Funding Change Letter does not constitute an order for services under this Grant.
The effective date of hereof is upon approval of the State Controller or , whichever is later.
STATE OF COLORADO
John W. Hickenlooper, GOVERNOR
Department of Public Health and Environment PROGRAM APPROVAL:
By: Lisa Ellis, Purchasing & Contracts Unit Director By:
Date:
ALL GRANTS REQUIRE APPROVAL BY THE STATE CONTROLLER
CRS §24 -30 -202 requires the State Controller to approve all State Grants. This Grant is not valid until signed and dated below by
the State Controller or delegate. Grantee is not authorized to begin performance until such time. If Grantee begins performing prior
thereto, the State of Colorado is not obligated to pay Grantee for such performance or for any goods and /or services provided
hereunder.
STATE CONTROLLER
David J. McDermott, CPA
By:
Date
Page 1 of 1
Effective Date: 1 /6/09 -Rev 8/25/09
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