PROWERS COUNTY, COLORADO BOARD OF COMMISSIONERS  June 13, 2023  COMMISSIONERS BOARD ROOM, 2nd FLOOR OF COURTHOUSE  301 S. MAIN STREET, LAMAR, CO 81052 Mark Dorenkamp, Road & Bridge  7:30a.m.  Update (Hickory House Restaurant)  WORK SESSION  8:30a.m.  Ribbon Cutting Ceremony and Grand Opening  Cobblestone Hotel  9:30a.m.  CherylSanchez, Prowers Economic Prosperity Director  PEP update monthly  10:00a.m.  GaryH Harbert, Veterans' Service Officer  County" VSO Monthly Report and Certification of Pay  10:15a.m. 10:30a.m.  BOCC  Updates  Pete Hernandez, PC Consolidated Return Mail Center Manager  CRMC update  10:45 a.m.  PC Overflow Processing Center Program Manager  OPC update  1    MEETING AGENDA  Invocation Pledge of Allegiance Call Meeting to Order Roll Call  1:00 p.m.  CONSENT, AGENDA ACTION ITEMS:  1. Consider Approval of Adoption of Agenda 2. Consider Approval of Payment of Bills Presented and of Voiding Checks, ifany 3. Consider Approval of May 23, 2023 Meeting Minutes 4. Consider Approval of June 5, 2023 Special Meeting Minutes 5. Consider Approval of June 9, 2023 Special Meeting Minutes  Public Appearances  Anyone wishing to address the BOCC may do sO at the discretion of the Board and subject to a three-minute limitation. First Reading of Ordinance Prohibiting the Operation of Marijuana Cultivation Facilities, Marijuana Product Manufacturing Facilities, Marijuana Testing Facilities, and Retail  1:05 p.m.  Rose Pugliese, Esq.  Marijuana Stores Mark Westhoff County Administrator Update Rose Pugliese, Esq. County Attorney Update  1:20 p.m. 1:30p p.m.  Executive Session pursuant to C.R.S 924-6-402(4)(b) Conference with the attorney for the purpose of receiving legal advice on specific legal questions for matters related to the following: Part 1: Collective Bargaining, Part 2: Public Safety, and Part 3: Water  Authorities.  2    ACTIONI ITEMS:  1. Consider approval for correction to the Subdivision Application agenti item and correction of the Final Subdivision Exemption plat map agenda item for Carol M. Flint, correction the agenda items to read SW1/4 of Section 17, Township 17, 22 South, Range 45 West, as approved on January 24, 2023 by the BOCC and the final plat map was approved April 25, by 2. Consider Approval of County' Veterans Service Officer's Monthly Report and Certification of 3. Consider ratifying 5-26-2023 email poll approval for Payment of Bills and Payroll Presented in the Amount of $835,715.69, Department of Human Services Payment of Bills Presented in the Amount of $228,446.22 and H3C in the amount of $115,570.70 with the Certification date 4. Consider approval of SFY24 Amendment #5 of 24 QAA 182958 original Contract # 21 IHIA 159839 between the Colorado Department of Early and Prowers County Department of Human Services for the Early Childhood Council Program-Prowers County Department of Human Services, total funding amount was $514,066 with an expiration date of 9-30-2024 and authorizing Lanie Meyers-Mireles, Director of Human Services, to execute the document 5. Consider approval of Master Task Order Contract No. 23 FAA 00042, Task Order No. 2024*0447 for Prowers County Public Health to provide environmental health services effective 7-1-2023 to 6-30-2028, funding in the amount of $30,000 and authorizing Meagan Hillman, Public Health Director to execute the document electronically. 6. Consider approval of Contract Amendment No. 11 to the Substance Use Disorder Services Agreement between the Arkansas Valley County Departments of Social Services and Signal, and authorizing Lanie Meyers-Mireles, Department of Human Services Director, to execute 7. Consider approval of Contract Amendment #5 of21 IHIA1 168429 between Prowers County Department of Human Services and the Colorado Department of Early Childhood for the provision of the Colorado Fatherhood F.I.R.E. grant and authorize Lanie Meyers-Mireles, 8. Consider approval of Master Task Order Contract No. 23 FAA 00042, Task Order No. 2024*0719, FY2 2024-2027, funding amount $331,314.00 for OPHP and authorizing Meagan Hillman, Public Health Director to execute the document electronically.  the BOCC. Pay- May 2023.  5-26-2023.  electronically.  the document.  Director of Human Services to execute the document electronically.  3    9. Consider approval of Contract Amendment #4, 23 IHFA: 182250, original contract #128142 between Prowers County and the Colorado Department of Human Services to provide support of the Child' Welfare Abuse and Neglect Hotline-Routine System, total amount of $5,162,133.85 with the expiration date of 6-30-2024 and authorizing Lanie Meyers-Mireless, Department of Human Services Director, to execute the document electronically. 10. Consider approval of Case Management Retention Phase 2 Grant Application for OLTC Retention Payments, in the amount of $750 per OLTC Staff Members and authorizing Meagan Hillman, Public Health Director to execute the document electronically. 11. Consider approval of Contract Amendment #2, 21 IHGA 184263 original Contract #: 21 IHGA 168850 between Colorado Department of Human Services and Prowers County Department of Human Services for use of The Work Number from June 1, 2022 through. June 30, 2024, total amount $59,360.63 for all State Fiscal Years and authorizing Lanie Meyers-Mireles to 12. Consider approval to Amend the 2023 Order for Authorized Persons and Authorized Signature on Checking Account document to remove Tamara Nickelson as an authorized agent and to 13. Consider approval of Credit Card Authorization Request for the following county employees: Bret Olinger, Nelson Marks, Racheal Ariatti, Ricardo. Juarez, and Troy Spears for the Prowers 14. Consider approval of Credit Card Authorization Request for Paula Gonzales, Finance 15. Consider approving Colorado Department of Public Health and Environment Brownfields Assessment Grant Application to update Phase 1 and Phase 2 Brownfields Site Assessments at 207 E Elm Street, Lamar, Colorado and authorizing Mark Westhoff, County Administrator to 16. Consider approving a Minor Subdivision application by S Bar Ranches, Inc., in the E2SE4SE4 of Section 19, Township 22, Range 46 West, the 6th P.M. The request is to subdivide the property into three separate tracts. The Property is located in an A-1 Irrigated. Agriculture Zoning District. This will be a Second Subdivision. The Planning Commission approved to forward the application to the BOCC with recommendations for consideration of approval on 17. Consider approval of Credit Card Authorization Request for Connie Martinez, Environmental  execute the document electronically.  add Paula Gonzales as a new authorized agent effective. June 1, 2023.  County Sheriff's Department, credit limit amount of $1,000.00 each. Director/Budget Officer, credit limit amount of $3,000.00.  submit the Application form online.  May 24, 2023.  Health Manager, credit limit amount of $1,000.00.  4    18. Consider approval of Task Order Contract Waiver #154, Amendment #5 to Original Contract No. 2020*0270 between Colorado Department of Public Health & Emergency Preparedness & Response and the Board of County Commissioners of Prowers County for services to improve medical and public health care preparedness, response, and recovery capabilities, funding amount is $42,709 with term ending June 30, 2024 and authorizing Meagan Hillman to 19. Consider ratifying 5-22-2023 email poll approval of a Letter of Congratulations sent to Mr. John Hainer for 2023 CHSAA Track and Field 1A State Championship in both shot and discus 20. Consider ratifying 5-26-2023 email poll approval of Lower Arkansas' Valley Area Agency on Aging (LAVAAA), Title III-B Older Americans Act Services and State Funding for Senior Services, grant application period. July 1, 2023 -J June 30, 2024 for Prowers Area Transit. 21. Consider approval of URHN Contract Amendment No. 1, 2023*0329, original Contract No. 2023*0329, funding in the amount of $199,994, term of7-1-2023 to 6-30-2024, and authorizing Meagan Hillman, Public Health Director to execute the document electronically.  execute the document electronically.  throw.  NOTE: This Agenda is provided fori informational purposes only. Action may be taken on any or all of the items. All times are approximate. If any given item is finished earlier than anticipated, the Commissioners. may move on to the next item. The only exceptions are public hearings on items which have had published notices of a If you need assistance in participating in this meeting due to a disability as defined under the Americans with Disabilities Act, please call 719-336-8030 at least three days prior to the scheduled meeting to request an  specific hearing time; those items will not begin until the specific time or after.  accommodation.  5    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested: 06/13/2023 Submitter: Michelle Hiigel, Land Use  Submitted to the County Administration Office on: 05/31/2023 Return Originals to: Michelle Hiigel, Land Use Number of originals to return to Submitter: 0  Contract Due Date: N/A  Item Title/Recommended Board Action:  Consider approval for a correction to the Subdivision Application agenda item and correction of the Final Subdivision Exemption plat map agenda item for Carol M. Flint, correcting the agenda items to read SW % of Section 17,Township 22 South, Range 45 West of the 6th P.M, in place of WY of Section 17, Township 22 South, Range 45 West oft the 6th P.M., as stated on the application and plat map. The Minor Subdivision Application was approved on January 24, 2023 by the BOCC and the final plat map was approved on April 25, 2023 by the BOCC.  Justification or Background: the application and final plat map. County: N/A Federal: $  Correct agenda item verbiage to read SW  Section 17, Township 22 South, Range 45 West ofthe 6th P.Min place of W %0 of Section 17, Township 22 South, Range 45 West oft the 6th P.M, as stated on  Fiscal Impact: This item is budgeted in the following account code:  State: $  Other: $  Approved by the County Attorney on: Additional Approvals (ifr required):  PLEASE ATTACH THIS SHEETT TO ALL. AGENDA ITEMS WHEN SUBMITTINGTO  COUNTY ADMINISTRATION.  THANK YOU!    Subdivision Exemption No.  SUBDIVISION APPLICATION AND SUMMARY FORM  PLEASE! READI NOTE. AND SIGNI BELOW:  THE SUBMITTED, APPLICATION PACKAGE REQUIRES SPECIFIC: EPOKISINPORMATON WHICHT MAYNOT BEA ADEQUATE ASI DETERMINED THROUGH THEI REVIEW PROCESS. ADDITIONAL INFORMATIONI MAY BE REQUIRED,, ALSO, THE ACCEPTANCE OF THE. APPLICATION PACKAGE DOESI NOTI MEAN THE: SPECIFIC INFORMATIONI HASI BEEN APPROVED, ANDI INI FINALI FORM. REVISIONS TO THE INFORMATION. AND/OR REPORTS! MAYI BEI REQUIRED. REQUESTS FOR WAIVERSOF/ ANY OFTHESE REQLIREMENTSMUSTI BE ACCOMPANIEDI BY ALETTER OF JUSTIFICATION. THE PROWERS COUNTY PLANNING COMMISSIONERS WILLHEAR THE WAIVER QUBSTCONCURENTLY WITH THE APPLICATION. DENIAL OF THE WAIVER REQUEST! SHALL RENDER' THIS APPLICATION INCOMPLETE. ANDI RESULTI INT THE REQUIREMENT FOR SUBMITTAL ACCEPTANCEDATE, ANDI REVIEW PERIOD. YOUR SIGNATURE BELOW INDICATES  ANEW  ACCEPTANCE OF' THESE CONDITIONS. Date: 12/10/2023 must be included,  Carot 727. Iht  Ifothert than owner's signature, a letter ofconsent authorizing the pplicantreprsentative Aoplemh/Rprerane 10 act int the owner's Signature behalf  Property Owner: farel 771- 1ht  Address: 34500 L113 Sealasiest  Telephone Number: 712-336-2167 Email DhreHaa  Applicant's Representative: Address: Telephone Numbers: Surveyor or Engineer:  Email:  Telephone:  Location of Subdivision: Quarter_ SI) Section 17 Lot  Subdivision (15,2d, etc.)_ Aad  Township_22 Range 45 w or  Block  Subdivision  >>>>>>>*Attach Copy of Deedk<<<<<<<<<  Tax parcel number of property (County Assessor's Records) SACD-31-67 Current land classification as per Assessor's Records guigiag Ifirrigated, will water shares be allocated to the subdivided parcel? Ist there a Deed of Conservation Easement attached to this property?.  Yes Yes_ V No  No  IfYES, attach copy    Proposed Use ofLand Sprtraestal  Proposed Water Source  MI  Proposed Means of Sewage Disposal MA Proposed Road Access Ciiint Proposed Lot Size_ 2A8  The Prowers County Planning Commission recommends approval of this request  for subdivision exemption. Prowers County Planning Commission, Chair hipLhl  Dated this IA day of aay ,2023  The Prowers County Board of County Commissioners grants approval of this request  fors subdivision exemption. 60 ok  Prowers County-Board apchmgCammisimes, Chair Dated this 24 day of Jncanym23    SUDIVISION PLAT SECOND SURDIVISION  SECONR  THK.  324  swi"  OF   hdsi aar   SURVEYOR'S STATEMENT  2023  POALNE OHES ARR  SUBDIV/SION PLAT  CAROL FINT  TAMAR  COLCRADO    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested: 6/13/2023 Submitter: Gary Harbert, Veterans Officer  Submitted to the County Administration Office on: 6/2/2023 Return Originals to: 1Original BOCC, 1 Original to Veterans Office  Number of originals to return to Submitter: 1  Contract Due Date:  Item Title/Recommended Board Action: Consider Approval of County Veterans Service  Officer's Monthly Report and Certification ofl Pay - May 2023 Justification or Background: Briefoverview. for the Commissioners) Fiscal Impact: This item is budgeted in the following account code:  County: $  Federal: $  State: $  Other: $  Approved by the County Attorney on: Additional Approvals (if required):  PLEASE ATTACH THIS SHEETTO ALL AGENDA ITEMS WHEN SUBMITTINGTO  COUNTY ADMINISTRATION.  THANK YOU!    Colorado Department of Military and Veterans Affairs  County Veterans Service Officers Monthly Report and Certification of Pay  TERAVE County of  Prowers  Month of May 2023  DMVA Telephone Calls Appointments Outreach Total Served  88 29  117 1  Surveys Submitted  Certification by County Veterans Service Officer been employed as a county veteran service officer at a rate of:  Ihereby certify that the above monthly report is true and accurate to the best of my knowledge and belief.Ihave  34 hours per week or fewer X_35 hours per week or more For the month of May  2023 from Prowers County.  Bars akus Signature ofCounty Veterans Service Officer  6/1/2023 Date  Certification by County Commissioner or Designee  Ina accordance with CRS28-5-202, Ihereby certify the appointment of our county veterans service officer. In accordance with CRS 28-5-707, I hereby certify the accuracy of the Report CVA-26 revised September 2021.  County Commissioner or Designee of  PROWERS  County Date  This certification, submitted monthly, properly signed and executed is considered as application for the monetary benefits to the County General Fund in accordance with 28-5-804 (2002) Colorado Revised State Statute.  Submit this form no later than the. 15th day thej following month to:  Colorado Division of Veterans Affairs East vampemvasole-cous  CVA-26 November 2021    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested: 6-13-23 Submitter: Paula Gonzales, Payroll Director  Submitted to the County Administration Office on: 5-26-23  Return Originals to: Sheryl Reifschneider and Jana Coen, County Clerk  Number of originals to return to Submitter: 1  Contract Due Date:  1. Item Tite/Reommended Board Action:  Consider ratifying 5-26-2023 Email Poll approval for Payment of Bills and Payroll Presented in the Amount of $835,715.69, Department of Human Services Payment of Bills Presented in the Amount of $228,446.22 and H3C in the amount of $115,570.70  with the Certification date 5-26-2023.  Justification or Background:  Fiscal Impact: This item is budgeted in the following account code:  County: $  Federal: $  State: $  Other: $  Approved by the County Attorney on: Additional Approvals (if required):    PROWERS COUNTY APPROVE TO PAY  APPROVE PAYMENTS AS HEREIN SET FORTH. CHECK NUMBERS AS LISTED BELOW ARE ALL INCLUSIVE, ARE SET OPPOSITE THEIR NAMES, AND TOTALING THE SUM OF: $869,149.69  DRAWN ON COUNTY GENERAL FUNDS.  DATED. AS OF: May 26, 2023  #  A/P $ 33,434.00 $ $ $ $ $ $ $ $ $  PAYROLL 315,130.98  FRINGES 84,572.79  COUNTY GENERAL FUND ARPAI FUND FSA ACCOUNT BOOKING FEES ACCOUNT PUBLIC HEALTH AGENCY ROAD & BRIDGE FUND SALES & USE TAXI FUND CONSERVATION TRUST FUND CAPITAL FUND OTHER AGENCIES FUND LODGING TAXI FUND CRMC FUND OPC FUND  549.53 97,076.96 64,049.48  24,774.94 16,175.73  211.75 100,683.31 76,954.25 654,656.26 daadl COMMIBSIONER. M AISSIONER et CLERKTOTHE BOARD  63.68 30,327.74 25,144.55 181,059.43  Totals DATE: May 26, 2023 DATE: May 26, 2023 DATE: May 26, 2023 DATE: May 26, 2023 Total Paid Approve To Pay AP + Fringes Total Pd Certification Payroll Total Payroll + Fringes  33,434.00    ibonts  $ $ $ $  869,149.69 214,493.43 214,493.43 835,715.69  STATE OF COLORADO) COUNTY OF PROWERS) Audy Wll Proyfers Coynty Treasurer's Office  Ending Check No. Beginning Check No. Total Number of Checks:  69301 69285 1 17  jss:    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested: 6-13-2023 Submitter: Department of Human Services  Submitted to the County Administration Office on: 5-22-2023 Return Originals to: Department of Human Services Number of originals to return to Submitter: 1  Contract Due Date: ASAP  Item Ttle/Recommended Board Action:  Consider approval of SFY24 Amendment #5 of 24 QAA 182958 original Contract # 21 IHIA 159839 between the Colorado Department of Early and Prowers County Department of Human Services for the Early Childhood Council Program-Prowers County Department of Human Services, total funding amount was $514,066 with an expiration date of 9-30-2024, and authorizing Lanie Meyers-Mireles, Director of Human Services, to execute the document  electronically.  Justification or Background:  This item is budgeted in the following account code:  Fiscal Impact: This item is budgeted in the following account code:  County: Federal: State: Other:  $_ $_ $ - $    COLORADO  Colorado Department of Early Childhood  Department o! Early Chuldhood VENDOR CONTACT INFORMATION SHEET Legal Name of Vendor asi its should appear on the Contract/Purchase Order including any dba:  Prowers County Department of Human Services dba: Routs and Wings for Children; Baca and Prowers County Early  Childhood Council Address: 10015 S.. Main. PO BOX 1157 City: Lamar FEIN# 84-1132868  State: CO Zip Code: 81052  County: Prowers 06/2024 For-Profit Government  State of Incorporation Fiscal Year End Date (MM/DD)  Unique Entity Identifier Y8C4HSXY95M6 (UEI) (From SAM.gov) DUNS: 014854343 Type of Entity (please mark one): Individual Professional Corporation (PC) Sole Proprietor  Not-For-Profit Corporation Limited Liability Company (LLC) Joint Venture  Limited Liability Partnership (LLP)  Primary Contact to Receive ALL Correspondence: Name: Lanie Mevers-Mireles Title: Director Email: dssdirectoras prowerscounty.net Phone: 719-336-7-86x105 Individual Signing Contract: Name: Ron Cook  CFO or Financial Contact: Name: Lisa McCullough Title: CFO Email: Imccullougha prowerscount.net Phone 719-688-3696  Coordinator Contact: Name: Courtnev Holt- Rogers Title: Coordinator Email: cholta prowerscounty.net Phone 719-336-7486x105  Title: Chair. Prowers County Commissioners Email: rcookia prowerscountv.net Additional Contacts for DocuSign Review:  Phone:  The Department of Early Childhood collects signatures via DocuSign. Please list below any individuals that need to be included in the DocuSign process prior to the final signature (example: Director's Assistant. Attomey, etc):  Vendor Specific Instructions for Emails of Preliminary Approva/Docusign (example: PI/Facuity Member. Name):  Name: Title: Email: Sign or CC? CC  Rose Pugliese Cnunty Attornes Peyesh-fmaxmalen  Isyour agency set up for Electronic Deposit with the State of Co?  Yes X No 2164 Dependen! on cummissioner meeting dates.  IfYes. please list the last 4 digits oft the account number payments should be sent to: How long does your agency and/or board need to review and return the signed contract? IMPORTANT When submitted with a Solicitation, please complete the following:  Vendor should read the entire! Solicitation document beforc submitting a BidProposal/Quote. Solicitation is subject to the conditions stipulated and ina accordance with the specifications: set forth and/or attached tot the Solicitation. All Solicitations shall be quoted F.O.B. destination. unless otherwise specified, tot the delivery location orj job site listedi in the Solicitation.  201/23  Revised 07/08/2022  Hlhyanalo    COLORADO DepartumentofFarty Childhood  CONTRACT AMENDMENT #5 SIGNATURE AND COVER PAGE  State Agency Coloradol Department of Early Childhood 710 South Ash Street Glendale, CO 80246 Contractor Prowers County Department ofH Human Services POBOXI 1157 1001 South Main Street Lamar, CO81052 Current Contract Maximum Amount Initial Term State Fiscal Year 2021 appropriated and added to this contract for: Quality Improvement (QI) the maximum amount payable for QI-GAE is subject to appropriated funds, not to exceed $5,506,000 Expanding Quality inl Infant Toddler Care (EQIT)- the maximum: amount payable for EQIT-GAE iss subject to appropriated funds, not to exceed! $511,134 Micro Grant (MG) - thei maximum amount payable for MG-GAE is subject to appropriated funds, not to exceed $424,096 The QI-GAE, EQIT-GAE, and MG-GAE shall be split among other Early Childhood Council (ECC) vendors. See Exhibit F, Section 12. General Accounting Encumbrance (GAE). Extension' Terms State Fiscal Year 2022 *Two General. Accounting Encumbrances (GAE) havel been appropriated and addedt tot this contract for: Quality Improvement (QI)- the maximum amount payable for QI-GAE iss subject to appropriated funds, not tos exceed Expanding Qualityi inl Infant1 Toddler Care (EQIT)-t the maximum amount] payable for EQIT-GAE iss subject to appropriated funds, not to exceed $505,000 The QI-GAE and EQIT-GAE: shall bes split among other Early Childhood Council (ECC) vendors. Seel Exhibit F, Section 12. General Accounting Encumbrance (GAE). Statel Fiscal Year 2023 *Two General Accounting Encumbrances (GAE) have been appropriated and addedt tot this contract for: Quality Improvement (QD)- int the amount of $7,626,301,is subject tos appropriated funds, Expanding Qualityi in) Infant Toddler Care (EQIT): -int the amount of$647,000i iss subject tos appropriated funds The QI-GAE and EQIT-GAE: shall bes split among other Early Childhood Council (ECC) vendors. Seel Exhibit) F, Section 12. General Accounting Encumbrance (GAE).  Original Contract Number 21 IHIA 159839 Amendment Contract! Number 24QAAA 182958  Contract. Performance Beginning Date  July1,2020 September 30, 2024  $61,027*  *Three General. Accountingl Encumbrances (GAE) have been Current Contract Expiration Date  $115,131*  $6,283,201  $156,460*  Amendment Contract Number: 24 QAAA 182958  Page 1 of4  CDEC V.21 Rev. 07/08/2022    COLORADO Ppameidaycasahon State Fiscal Year 2024 *Two General Accounting) Encumbrances (GAE) have been appropriated anda addedt to this contract for: Quality Improvement (QI) - int the amount of$5,344,341,is subjectt to appropriated funds, Expanding Quality inl Infant" Toddler Care (EQIT)- int the amount of $627,000i iss subject to appropriated funds The QI-GAE andE EQIT-GAE shall bes splite among other Early Childhood Council (ECC) vendors. See Exhibit F, Section 12. General Accounting Encumbrance (GAE). Statel Fiscal Year 2025 Total for All State Fiscal Years  $160,492*  $20,956 $514,066*  Signature Page begins on next page * and to bind the Party authorizing his orl her signature.  THE: PARTIES HERETO HAVE EXECUTED THIS AMENDMENT  Each person signing this Amendment: represents and warrants that he ors she is duly authorized to execute this Amendment  CONTRACTOR  STATE OF COLORADO Jared Polis, Governor Colorado Department of Early Childhood Lisal Roy, Ed.D., Executivel Director  Prowers County Department of Human Services  By: Ron Cook, Chair, Prowers County Commissioners  By: Lisa Castiglia, Deputy Chief Financial Officer  Date:  Date:  In accordance with $24-30-202 C.R.S., this Amendment isr not valid until signed and dated below byt the State Controller or an  authorized delegate. STATE CONTROLLER RobertJaros, CPA, MBA, JD  By:  Andrea Eurich/Toni' Williamson/Telly Belton  Amendment Effective Date:  Signature and Cover Pages End -  Amendment Contract Number: 24 QAAA 182958  Page2of4  CDEC V.21 Rev. 07/08/2022    COLORADO Department ofEarly Childhood  1. PARTIES State. 2. TERMINOLOGY  This Amendment (the "Amendment") to the Original Contract shown on the Signature and Cover Page for this Amendment (the "Contract") is entered into by and between the Contractor, and the Except as specifically modified by this Amendment, all terms used in this Amendment that are defined in the Contract shall be construed and interpreted in accordance with the Contract.  3. AMENDMENT EFFECTIVE DATEAND1 TERM A. Amendment Effective Date  This Amendment shall not be valid or enforceable until the Amendment Effective Date shown on the Signature and Cover Page for this Amendment. The State shall not be bound by any provision of this Amendment before that Amendment Effective Date, and shall have no obligation to pay Contractor for any Work performed or expense incurred under this Amendment either before or after ofthe Amendment term showni in $3.B ofthis Amendment. The Parties' respective performances under this Amendment and the changes to the Contract contained herein shall commence on the Amendment Effective Date shown on the Signature and Cover Page for this Amendment, or July 1, 2023, whichever is later, and shall terminate  B. Amendment Term  on the termination oft the Contract.  4. PURPOSE  Prowers County Department ofHuman Services and shall serve as the fiscal agent for Roots and Wings for Children, Baca and Prowers County Early Childhood Council. Statutorily Early Childhood Councils (ECC) support the effective delivery ofe early childhood services in the areas of early care and education, family support, mental health, and health. ECCs increase and sustain the quality, accessibility, capacity, and affordability of early childhood services for children and their parents. ECCs provide local level supports for licensed programs required to participate in Colorado Shines by offering technical assistance and quality improvement supports to programs pursuing higher quality levels. This Amendment extends the Contract Expiration Date, increases  funds for SFY24 and SFY25 services and amends Exhibits A, B, Fand G. The Contract and all prior amendments thereto, ifany, are: modified as follows:  5. MODIFICATIONS  Amendment Contract! Number: 240 QAAA 182958  Page 3 of4  CDEC V.21 Rev. 07/08/2022    COLORADO DepartmentofEartyt Childhood  A. Extend the Contract Expiration! Date from June: 30, 2023 to September 30, 2024 The Contract Initial Contract Expiration Date on the Contract's Signature and Cover Pagei is hereby deleted and replaced with the Current Contract Expiration Date shown on the B. Increase the Contract Amount for SFY24 by $160,492 and SFY25 by $20,956 and Increases thel Maximum Amount for All State Fiscal Years from $332,618 to $514,066. The Contract Maximum Amount table on the Contract's Signature and Cover Page is hereby deleted and replaced with the Current Contract Maximum Amount table shown on the Exhibit. A - Amendment #5, which is attached and incorporated by this Amendment, shall be Exhibit B - Amendment #5, whichi is attached andi incorporated by this Amendment, shall be Exhibit F - Amendment #5, which is attached and incorporated by this Amendment, shall Exhibit G-A Amendment #5, which is attached and incorporated by this Amendment, shall be  Signature and Cover Page for this Amendment.  Signature and Cover Page for this Amendment. :. Exhibit. A - Statement of Work added to Exhibit A of the Original Contract. added to Exhibit B oft the Original Contract, E. Exhibit F -4 Additional Provisions  D. Exhibit B - Budget  replace Exhibit F - Amendment #4 oft the Original Contract. F. Exhibit G-S Supplemental Provisions for Federal Awards added to Exhibit G ofthe Original Contract. LIMITS OF EFFECTAND ORDER OFI PRECEDENCE  This Amendment is incorporated by reference into the Contract, and the Contract and all prior amendments or other modifications to the Contract, ifany, remain in full force and effect except as specifically modified in this Amendment. Except for the Special Provisions contained in the Contract, in the event of any conflict, inconsistency, variance, or contradiction between the provisions ofthis Amendment and any oft the provisions of the Contract or any prior modification to the Contract, the provisions of this Amendment shall in all respects supersede, govern, and control. The provisions of this Amendment shall only supersede, govern, and control over the Special Provisions contained in the Contract to the extent that this Amendment specifically  modifies those Special Provisions.  Amendment Contract Number: 240 QAAA 182958  Page 4 of4  CDEC V.21 Rev. 07/08/2022                                                                    Exhlbit B-  #S  COLORADO  Colorado Department of Early Childhood BUDGET' WITH. JUSTIFICATIONI FORM Program Contact' Namea andT Title Phone Emall FiscalContact) Name and Tille Phone Email  Prowers County Departmento oft Humans Services Baca andF Prowers Early Childhood Council) July! ,2023- June3 30,2 2024 Early Childhood Counci! EarlyChildhonds Systems Building (ECSB) ChildCarc Resource &F Referral (CCR&R) FCCHNavigator Description ofv Worka and FringeE Benefits Include: CCOERA, Visionl Insurance, Annual Lifel Insurance, paidy vacationa ands sickd days. submitalo ofof fundinge expendiures, reporty writinga: Funding/ Allocation, Billing, Data Collectiona and Dissemination. PCDHS accounlant,  Courncy Holl-Rogers 719-336-74B6x105 chalpoweacounynd. Liso McCullough, CFO 719-336-3696 macduphépoesonyae.  Contractor Name (FiscalA AgentF For.Rooisa andV Wingsf for Children:  BudgetF Period  ProjectName Colorado Shines Qualily Improvement( (CSQI)  Expenditure Categories Personnels Services- Salaried Employees Grossor 566,703 58,111  SFY2024 TutalA Amount 748 25,436 7,650 33,086 SFY2024 TotalA Amount FCCH Requested from 21,836 28,235 15,057 SFYZ 2024 TotalAmount FCCH Requesiedf from 3,000 2,000 690 5.690 SFY2 2024 TotalA Amount FCCH Requested from 7,500 800 a 1,200 5 : s 1.550 10.580  Total  Percent CostB Based CostB Based Child Car Numbero of) ofTime on Percent onPercent Resource& Months an) on ofTime for ofTimef for Referral FCCH Requested from 25%45 11,222 7,481 5,985 195 2.250 2,700 2,250 s 450 S  Pasition Tidle  Salary Fringe Project Praject (ECSB) (CSQI) (CCR&R) Navigator CDEC  Council Coordinator Oversighto ofp program, Attendr meetings as necessary,  Accounling supports slaff Processing ofp payments, providingr monlhlya accountingto $40,000 $5,000  Total Personnels Services (including Iringet benefits) s 13,472 10.181s 8.235_ 1.198  Contractors/C Consultants (payments tot thirdp particso ore entities)  Name Comerstone Family ofhome providers. Resource Center roferral referal  Descriptiono afltem  ECSB CSQI CCR&R Navigator CDEC 2,235 2,000 s 24.000 3,5005 5,000 6,557  Councilo ouircach- Assistance ando oversighio ofp program forP Prowers andE Baca-allendr mcclings, suppor forr programs, recruitmen!! 1,500 2,500 1,000 16,836  QIN Navigator, resourcea and Outrcachi oprogramsu voi introducc andc cneourage progranp partcipation? andir inccntives Coaching/Resource: and Coachingp programs loa achievet then nextq qualityl level  TamicamrstanCmaliame, 7,235s 9.500S 31.557s 16,836 5 65.128  Travel  Item Hotel Meals/Perdiem Item. Genuralo offices supplics Gencral ollices supplics Marketing Matcrials Marketing matcrials, printedi matcrials used forn rocruitment Website Cellp phune/lpad Momberships Materials  Description ofltem  ECSB CSOI CCRAR Navigator CDEC 1.500 s 1.500 1.1005 276s  Travel Rcimburscment Average milcage forc coachingy visits4 400m miles(RT)  Holels costs forn meetingsupiol 1Oniphts Per.di diemupto 10days  900 4145  Totel Travels 1,314/s 1,500s 2,876s  Supplles & Operating Expenses. Deseripilon ofltem  ECSB CsQI CCR&R Navigalor CDEC 3.500 2.000 2,0005 2.0005 1,000 2,015 2985 10,000 200s 200 2005 200 1,200 1.5505 91s 5,5695 4,000 s 920s  Website cellp phone/ipad100; pern month ECCLAEconncct Matcrials needed locnhances quality  Totel Supplies & Operating Espenses's 8.541s 10.769s 8.215s 4,1055 31.630  Pagelof3    Exhibit) B- Amendment #5  Itemst thate canaot bei iacludedin Modifled TotalD Direct Cos (MTDC) ltems listedint thiss sections shouldr not beir includedi in otbers sections  SFY2024 Total/ Amount FCCH Requestedf from 2.0005 9.000 15,958 $24,958  ltem Scholarships  Deseriptiono ofltem  ECSB CSQI CCR&R Navigalor CDEC  Scholarships forhighere cducstionb top providers  3.5005 3,500S  Participant Support Costs Stipends shallbep providedi lop providers ford complctiono ofc collegeo courses, inccntivesf forc continuinge carca and 2,5005 4,656 5,000 3,8025 S  continuingo oducation, supportf forc childo cared duringo conlinuinge educationh hours, assistancef forie Irvelo expenses tolrainings, anda anyo other opportunitics loa assisip providers (Example: incentives, childc carc, gilc cards, clc.)  Totall Items thatc cannotb bei includedi in MTDCS 6,000s 8,156_s 5,00D5 5,802 MODIFIEDT TOTALDIRECT COSTS (MTDCI 30,306 5 31,721s 48,133 22,139 132,299  TOTALI DIRECT ÇOSTSS 36,562s 40,106s 55,883 27,941s 160,492  Uniform Guidance 200,68- MTDCr mcans allo dirct salariess andy wages, applicable fringeb benefits, materials ands supplies, services travel, andu upioihef first$25,0000 ofeach subaward. MTDCe excludes cquipment, capital expenditures, cherges for poliento care, rental cosis, witionn remission, scholarships and fellowships. participunt supporte costs and thep portion ofcachs subawardi ine excess of$25,000.  lodirect Costs  notto exceed 10% uniess Negotiated FederalI Indirect Costr rateo or Negotlated Statel Indirect Cost ratels ise ettached!  SFV2024 TotalA Amount FCCH Requested from  Item  DescripHono ofltem  ECSB CSQI CCR&R Navigator CDEC  Noc cosiss shallber reimbursed byCDEC fori thise category.  Totall Indirects  TOTALE EARLY CHILI DHOODS SYSTEMS BUILI DING (ECSB)! 36,562 TOTAL COLORADOS SHINES QUIALITY IMPROVEMENT (CsQDs 40,106  TOTAL CHILD CARE RESOURCE & REFERRAL (CCRAR)S 55.883  TOTALI FCCH Navigators 27.941 TOTALAMOUNTE REQUESTEDFRONIG CDECS 160.492 PERCENTAGE OFE BUDGETE BVF PROJECT SFV2024 ECSB CSQI CCR&R Navigator TotalPereentage 2594 35%  FCCH 17%L 100%  PERCENTAGE OFE BUDGETI BYT PROJECT 23%  "Figuresa arer mundedu usimg banics ccoumtings Mandards. (0A0-8495 0:0.50-099-  Page2of3    Exhibit B- Amendment #5  COLORADO Daparmesstianyo acooa  Colorado. Department ofl Early Childhood BUDGET' WITHJUSTIPICATION FORM  Prowers County! Department of Human Scrvices Bacaa andF Prowers Early Childhood Council) July 1,2024- September 30, 2024 Early Childhood Council Availabilityo ofCare (AOC)F Family Child Care Home! Navigator (FCCH)  Progrem Contact Name andl Tlde Phone Emall Fiscal Contact Name and1 Tide Phone Email  Courtney Holl-Rogers 719-336-7486x105 chol@powerromiynat LisaN McCullough,CFO 719-336-3696 malAppTSNYN.  Coatractor Name (Fisçal Agent For:Roots and Wings for Children;  Budget Perlod Praject Name  Expenditure Categories Grosso or S66,703 $8,111  Personnel Services Salarled] Employees  SFY 2025 Total Amount CDEC 2,244 900 3,144 SFY 2025 Total Amount FCCH Requested from CDEC S S SFYZ 2025 SFY 2025 17.812 17,812 SFY2025 SO 20.956 20,956 SFY2025  Total Percent Child Care Number of ofl Time Resource& Months on on Referral FCCH Requested from 12 3%s 1,496 $ 748 S 2%s 450 $ 450 s  Description of Work: and Fringel Benefits Include: CCOERA, Vision Insurance, Annual Lifc Insurance, paid vacation ands sick days. submittal ofoff fundinge expendilurcs, report wriling. FundingA Allocation, Billing, Data Callection and Dissemination. PCDHS accounlant.  Position Title  Salary Fringe Praject Praject (CCR&R) Navigator  Council Coordinator Oversight ofp program, Attendr meetings ast nccessary,  Accountings supports staff Processingo ofp payments, providingr monthly accountingto $40,000 $5,000  Total Personnel Services (including fringe benefits)! $ 1,946 $ 1,198 S  Contractem/Comaltami (payments tot third parties or entities)  Name Item Item Materials  Descrlption ofl Item Travel Description of Item Supplies & Operating Expenses Description ofl Item  CCR&R Navigator  No costs shall bcr roimbursed by CDEC fort this catcgory. Noc cosis shall! ber rcimbursed by CDEC fort this category, Materials neededt to enhance quality andr retaing providers Noc costss shall ber reimbursed byCDEC fort this category.  Total Contractior/Comsulanu! S  CCR&R Navigator Requested from CCR&R Navigator Requested from 5 12.025 5.787 S CCR&R Navigator Requested from  Total Travel_s  Total Supplies & Operating Expensess 12,025_s 5,787s  Items thate cannat bei includedin Modified1 Totall Direct Costs (MTDC) liems listedi in thiss sections shuuld nat bei includedi in others sections  Item  Description ofl Item  Total Items thato cannot bei includedi in MTDC S  TOTALI DIRECT COSTS $ 13,971s 6,985s  MODIFIED1 TOTALI DIRECT COSTS (MTDC)S 13,971 S 6,985 S  Uniform Guidance 5200.68-MTDC means alld directs salaries andy wages, applicable fringe benefits, materials ands supplies, services, travel, andu upl tot thef firsts $25,000 ofcachs subaward. MTDCe excludese equipment, capital expenditures, chargesf forp patient care, rental costs, tuition remission, scholarships and fellowships, participants support costs andt thep portion ofeachs subaward ine excess of$25,000.  Indirect Costs Deseription ofl Item  [oot to exceed 10% unless Negotiated Federal Indirect Cost rate or Negotiated State Indirect Costr ratei is attached)  Item  CCR&R Navigator Requested from  Noc costs shallb ber reimbursed byCDEC fort this calcgory.  Total Indireet_s  TOTALAVAILABIITY OF CARE (AOC)s 13.971 PERCENTAGE OF BUDGET BVP PROJECT  TOTALE FCCH Navigator $ 6,985 TOTALA AMOUNT REQUESTEDI FROM CDEC PERCENTAGE OF BUDGET BYI PROJECT SFY2 2025  20.956  CCR&R Navigator Total Percentage  67%1  33% 100%  *Figures are rounded using basic accounting stondards. (0.00-0.49-0;0 0.50-0,99=1 1.0)  Page3of3    COLORADO Department ofEarly Childhood  Exhibit F- Amendment #5  ADDITIONAL PROVISIONS  1. SERVICE PROVISIONS  The Contractor shall provide the services according to the plans submitted int the "Statement of Work", attached and incorporated herein by this reference as EXHIBIT A. Ina all cases, the descriptions, plans, timetables, tasks, duties, and responsibilities oft the Contractor as described in the Statement of Work, shall be adhered to in the performançe of the requirements oft this contract. In the event ofa conflict, the terms and conditions ofthis contract shall control over the Statement ofWork.. Any significant changes to the Statement of Work (SOW) The Contractor shall bei responsible for the achievement ofa any goals and objectives as specified within the Statement ofWork (EXHIBIT A) of this contract unless written notice of any modifications are furnished by the State to the Contractor allowing adequate time for compliance during the term oft this contract. The Contractor shall provide to the State a copy of any executed subcontract between the Contractor and any provider ofservices to fulfill any requirements oft this contract. Subcontracts shall be emailed to the Contract  require an amendment to the contract. 2. GOALS. AND OBJECTIVES  3. COPY OF SUBCONTRACT Representative upon execution.  4. PAYMENT  Inc consideration oft the provision of services and reporting and subject to all payment and price provisions and further subject to verification by the State off full and: satisfactory compliance with thet terms oft this contract, the State shall pay to the Contractor an amount not to exceed the amount specified in the Budget (EXHIBITI B), of A. The Contractor shall submit requests for payment to CDEC Invoicing@stateço.us no less than monthly  this contract.  on forms prescribed and provided by the State.  B. Payment shall bei made on a cost reimbursement basis for services rendered.  C. Itisu understood any vacancy savings in the personnel category and/or any savings in any other category shall require written approval from the State priort to any redistribution of any savings by the Contractor. ANY COST SAVINGS THAT. AREI REDISTRIBUTED BY CONTRACTOR WITHOUT WRITTEN D. ITI IS UNDERSTOOD: ANY COSTS THAT: EXCEED THE CONTRACTED AMOUNT SHALL NOT BE PAID BY CDEC. IfContractor has a legitimate need for additional funds, the Contractor shall request additional funds from the CDEC 60 days prior to projected depletion of contracted funds. CDEC shall review each request and notify Contractor in writing of approval or denial. Approval ofa additional funds shall require an official modification to the Contract by Amendment or Option Letter, E. Timely Invoicing - Invoices shall bes submitted no later than 30 days following the last day of the month. End of State Fiscal Year invoices are on a compressèd timeframe. Invoices for all services provided prior to. June 30th shall be invoiced by. July 5th. Contractors who are unable to provide the invoice by. July 5th shall notify the state oft the amount to be booked as accounts payable by. July 13th by sending an email to  APPROVAL SHALL NOT BE REIMBURSED BY THE STATE.  Page 1of6  Revision Date 03/01/2023    COLORADO Department tofE Early Childhood  ExhibitF-A Amendment #5  CDEC Invoicing@suate.co.ls Final invoices for services prior to. June 30th shall be submitted by F. The Contractor shall: maintain source documentation to support all payment requested pursuant to this contract. All source documentation shall be provided to the State by the Contractor upon request. G. Itist understood that the State reserves the right to offset funds pursuant to this contract based on the discovery of overpayment or improper use off funds by the Contractor. Overpayment or improper use of funds is interpreted to apply to specific terms of prior year contracts, and includes without limitation requirements oft the Generally Accepted. Accounting Principles (GAAP) issued by the American Institute ofCertified Public. Accountants, and applicable sections ofthe Colorado Revised Statutes. H. The State shall review monthly invoices throughout the fiscal year. If, after a number of months, the State determines the Contractor is not needing/using the funding allocated for the Contractor's work in1 the Contract, the State shall remove these funds from the contract budget by Option Letter for a proportional reduction ofservices with prior written notification to the Contractor. This provision does not allow for a  September 14th. Invoices received after September 14th may not bej paid.  reduction in the rate of pay.  S.PARTICIPATION meetings related to this contract. 6.SUPPLANTING  The Contractor representative(s) is required toj participate in any Department of Early Childhood sponsored Payments made to the Contractor under this contract shall supplement and nots supplant other state, local or  federal expenditures for services associated with this contract.  7.1 BUDGET CHANGES  Contractor may request in writing adjustments to the direct costs in the current year budget (EXHIBIT! B) not toe exceed 10% oft the total budget. Requests shall be made in the form ofa written budget revision request to the appropriate program staff. Written approval for the budget revision shall be required prior to any changes to thel budget related to the budget revision request. The total dollar amount oft the contract budget cannot be changed as ai result of the budget revision request. Budget adjustment requests over 10%, adding new expense lines, and/or changes to the total dollar amount oft the budget require a formal amendment. No adjustments to Contractor may request in writing up to a 5% increase to the "Gross or Annual Salary" of ani individual employee ifaj position currently listed in the contract becomes vacant and the newi incoming employee shall be hired at al higher or lower salary. Noi increase within the salary range is authorized without prior written approval from CDEC. Adding additional staff requires an amendment to the contract. Vacancy savings cannot be used to change salary amounts for existing personnel without an amendment. Any change toj personnel requires prior written approval from CDEC staff. This process shall never change the Contract Maximum Amount. Contractor: must use available unused funds from either vacancy savings or another category within the contract. The revision request may not at any time compromise the integrity ofthe funded program as  the Indirect Costs portion of the budget are allowable without a formal amendment.  determined by CDEC program staff.  Page2of6  Revision Date 03/01/2023    COLORADO Ppammtaaychiasont  ExhibitF- Amendment #5  8. TRAVEL costs.  Travel costs must be listed in Exhibit B-1 Budget under travel including airfare, hotel, mileage and per diem A. Mileage shall not exceed the Federal mileage rate per htpsy/www.sigov/rave-resources. B. Per Diem shall not exceed Federal GSA per diem rates for the area of travel per C. Hotel rates cannot exceed any rate established for conference attendance. D. Usage of airfare or Out of State' Travel requires pre-approval from CDEC.  ttps/www.gsgov/ravel-resourees:  .SUBRECIPIENT  Contractors determined to be a Sub-recipient of federal funds shall complete the sub-recipient performance report and assessment survey at: htpsy/fomsgle/OTXGEabvipymdstd8 upon contract execution. Failure to complete the performance report and assessment survey shall delay payment to the Contractor.  10. CRITICAL INCIDENT REPORTING  Within 481 hours oft the occurrence ofa critical incident involving any child or family and/or an on duty agency staff member of any family support program staff funded through thel Department of] Early Childhood (CDC), the agency must report in writing the details of the critical incident to the CDEC Program Manager for the involved family support program. Critical incidents may include, but are: not limited to, awareness of an egregiousi incident of abuse and/or neglect, neari fatality, or fatality of any child currently enrolled in a family support program; involuntary termination ofap program staff's employment; criminal allegations involving program staff and related to his/her employment; negative media attention about the family support program; any major injury or threat to the security of an agency staff member while on duty and visiting an enrolled child  or family.  11. MANDATED REPORTING  A. All program staff are required by law to report suspected child abuse and neglect. Mandatory reporters must: report suspected child abuse and neglect to thel local county child welfare agency, the local law enforcement agency, or by calling the child abuse reporting hotline system at 1-844-CO-4KIDS (1-844- B. All program staff are required to take the online mandatory reporter training on the Colorado Department ofHuman Services (CDHS) Child Welfare Training System: tps/www.oloradowwis.ommandated.  264-5437).  reporter-training.  12. GENERAL ACCOUNTING ENCUMBRANCE (GAE)  There are three types of GAE that shall be utilized for this Contract: Quality Improvement (QI), Expanding Quality in Infant and' Toddler Care (EQIT); and Micro Grant (MG). All Early Childhood Councils shalll have access to all GAE types. All expenditures against the GAES require pre-approval from the Program.  Page 3of6  Revision Date 03/01/2023    COLORADO Department ofE Early Childhood  ExhbEF-Amendment #5  A. QUALITY IMPROVEMENT GENERAL ACCOUNTING ENCUMBRANCE (QI-GAE) 1. Payment for Quality Improvement (QI) to all contractors will be made as incurred, in whole or in part, from the total available funds to be utilized for Quality Improvement that includes: coaching activities and coach training, professional development ofs staff, purchases of program specific materials, temporary teaching funds, and capital expenditures. Iti is understood each contractor shall obtain prior written approval from CDEC prior toi incurring any costs related to QIf funds. Itisi further understood and agreed that the maximum amount of funds available statewide for the current fiscal year will be divided between all of the Early Childhood Council contracts. The State shall: not bel liable for any costs incurred without obtaining prior approval for a) Please refer to Page 1 for the amount available under the GAE: for the current fiscal year. 2. Payment to Contractor is made from available funds encumbered and shared across multiple contractors. The State may increase or decrease the total funds encumbered at its sole discretion and without formal notice to Contractor. No minimum payment is guaranteed to Contractor. The liability of the State for such payments is limited to the encumbered amount remaining of such  the expenditure ofQI funds.  funds.  3. Invoices shall be submitted separately for pre-approved QI expenditures.  a) The Contractor shall submit requests for payment to CDEC Invoicing@siate.co.s  B. EXPANDING QUALITY. IN INFANTTODDLER CARE GENERAL. ACCOUNTING  ENCUMBRANCE (EQIT-GAE)  1. Payment forl Expanding Quality in Infant Toddler Care (EQIT) to all contractors will be made as incurred, in whole ori inp part, from the total available funds shall be utilized to support the following quality improvement efforts: deployment oft the! EQI Infant Toddler Specialist Network toj provide evidence-based, infant toddler specific professional development, e.g. the Expanding Quality for Infant and Toddler (EQIT) 48-hour course, EQ Relate coaching for individuals completing the EQIT course, and support for the related costs of professional development for current and new infant toddler specialists. Tol be utilized for EQIT as outlined in Exhibit A - Statement of Work. Iti is understood each contractor shall obtain prior written approval from CDEC prior toi incurring any costs related tol EQIT funds. Iti is further understood and agreed that the maximum amount off funds available state wide for the current fiscal year willl be divided between all of thel Early Childhood Council contracts. The State shall not be liable for any costs incurred without obtaining prior approval for the expenditure ofE EQIT funds. a) Please refer to Page 1 for the amount available under the GAE: for the current fiscal year. b) Payment to Contractor is made from available funds encumbered and shared across multiple contractors. The State may increase or decrease the total funds encumbered at its sole discretion and without formal notice to Contractor. No minimum payment is  Page 4of6  Revision Date 03/01/2023    COLORADO Department ofE Early Childhood  ExhbEF-Amendment #5  guaranteed to Contractor. Thel liability of the State for such payments is limited to the c) Invoices shall be submitted separately for pre-approved EQIT expenditures. d) The Contractor shall submit requests for payment to! CDEC Invoicing@sate-co.s The indirect rate should: not bel bundled within the direct rate of an EQIT activity (course, coaching, data and reporting, etc.). In cases where a Council or fiscal agent charges ani indirect rate, these charges should be reflected within the invoice and calculated based on actual expenses.  encumbered amount remaining ofs such funds.  2. UPTORATES (direct and indirect).  The corrected rates include: a) $4,700 per EQIT Course;  b) $300 per EQIT Course to support data and reporting; and c) $100 per hour for EQI RELATE and LENA Coaching.  Because this is a cost reimbursement contract, charges for these activities should be based on actual costs, buti in no case should charges exceed the amounts noted for each activity. In cases where an Early Childhood Council is charging fees tol EQIT participants, this funding is considered program income. The program income must be documented and the agency must  3. PROGRAM INCOME  demonstrate how it is spent relative to the program.  C.MICRO GRANT GENERAL ACCOUNTING ENCUMBRANCE (MG-GAE)  1. Payment for Micro grants to all contractors shalll be made as incurred, in whole or in part, from the total available funds shall be used to support startup costs for licensed child care programs. It is understood each contractor shall obtain prior written approval from CDEC prior to incurring any costs related tol Micro grant funds. Iti is further understood and agreed that the maximum amount of funds available statewide: for the current fiscal year willl be divided between all oft the Early Childhood Council contracts. The State shall not bel liable for any costs incurred without a) Please refer to Page 1 for the amount available under the GAE: for the current fiscal year. 2. Payment to Contractor is made from available funds encumbered and shared across multiple contractors. The State may increase or decrease thet total funds encumbered at its sole discretion and without formal notice to Contractor. No minimum payment is guaranteed to Contractor. The liability ofthe State for such payments is limited to the encumbered amount remaining of such 3. Invoices shall bes submitted separately for pre-approved Micro Grant expenditures.  obtaining prior approval for the expenditure of Micro grant funds.  funds.  a) The Contractor shall submit requests for payment to! CDEC Invoicing@state.co.us.  Page! 5of6  Revision Date 03/01/2023    COLORADO Department ofEarly Childhood  ExhibiF-Amendment #5  13. GIFT CARDS  Thel Distribution of Gift Cards, where applicable, shall adhere to the following:  A. The contractor agency must have a written Gift Card Distribution Policy inj place and this] plan must bea approved by thel Department ofl Early Childhood before gift cards may be purchased. Thej policy must include maintaining an audit log of gift card purchases and disbursements and aj process for B. The contractor agency's gift card policy must ensure that gift cards cannot be redeemed for cash and must restrict the recipient from using gift cards for alcohol, firearms, tobacco, lottery tickets, or C. Gift Cards must be distributed tot recipients within five (5) business days of purchase. D. Gift Cards should be given at the conclusion of an event or upon completion of an activity or E. Contractor agency staff shall have recipients sign a form that includes the following: Date, Name of Gift Card Recipient, Purpose of Gift Card, Signature ofGift Card recipient acknowledging receipt of F. The contractor cannot request reimbursement for the cost of gift cards until distribution oft the gift cards has been made to recipients. Additionally, the contractor must maintain adequate documentation to show ai record ofall gift card distributions. G. The contractor shall bel held responsible fori inappropriate use of gift cards.  routine reconciliations. entertainment.  milestone.  Gift Card and Gift Card Amount.  Page 60 of6  Revision Date 03/01/2023    COLORADO Department of Farly Childhood  EXHIBIT G-A Amendment #5- Supplemental Provisions for Federal. Awards  Fort the purposes oft this Exhibit only, Contractor is also identified as" "Subrecipient." This Contract has been funded, in whole or inj part, with an award of Federal funds. In the event ofa a conflict between the provisions oft these Supplemental Provisions for Federal Awards, the Special Provisions, the Contract or any attaçhments or exhibits incorporated into and made ap part oft the Contract, the Supplemental Provisions for Federal Awards shall control. In the event ofa conflict between the Supplemental Provisions for Federal Awards and the FFATA Supplemental: Provisions (if any), and/or exhibit regarding SLFRF Federal Provisions, the terms rel FFATA and/or SLFRF shall control. Ift thes source oft the funding ofthe Contract is a grant, these Federal Provisions are subject tot the Award as defined in $2 oft these Federal Provisions, as may be revised pursuant to ongoing guidance from the relevant Federal or State of Colorado agency ori institutions of  higher education. 1) Federal Award Identification  Subrecipient: Prowers County Department of Human Services; ii. Subrecipient Unique Entity Identifier (UEI) number: Y8C4HSXY95M6; ii, Thel Federal Award Identification Number (FAIN)is CCDF Discretionary 2 2302COCCDD; ARP aserioy-10cocDcs ARP Salaton-Z10ICoCsCK2 CRRSA-2101COCCCCS: PDG-90TP0054; iv. Thel Federal award date is CCDF Discretionary - 10/28/2022; CRRSA-2/012021; PDG-12/272019;  ARPI Discretionary- - 4/14/2021; ARP Stabilization-0 04/14/2021;  Thes subaward period of performance start datei is CCDF Dserciomiy-1001201; ARP Dertiomiry-10012U.2 ARP Smablration-10012P2, CRRSA- -12/27/2020; PDG-12/31/2019; and end datei is:  CCDF Dlerciomiry-o202u, ARP Discretionary- - 09/30/2024; ARP Stabilization - 09/30/2023; CRRSA- - 09/30/2023; PDG-12/30/2023;  vi. Federal Funds:  Supplemental Provisions for Federal. Awards  Page 1of11  V2/(07-08-2022)    Contract Amount of Federal funds Total amount of Federal Total amount ofthe  or Fiscal obligated by this Contract funds obligated to the  Federal Award committed to Subrecipient by CDEC SFY24 $44,058.40; ARP Discretionary- $86,448; CRRSA - $O*; PDG-S0*  Year SFY24 SFY24  Subrecipient SFY24 $44,058.40; ARP Discretionary- $86,448; CRRSA-S0*; PDG-$0*  CCDF Discretionary- $44,058.40; ARP Discretionary- $86,448; CRRSA-S0*; PDG-$0* SFY25 SFY25  CCDF Discretionary- CCDF Discretionary-  ARP Stabllization-s0"; ARP Stabilization- - SO*; ARP Stabilization- $0*;  *An appropriation for SFY25 Quality Improvement ARPI Discretionary- (QI); and Expanding Quality in Infant Toddler Care (EQIT) General Accounting Encumbrance (GAE) is subject to appropriated funds not to exceed $5,273,079 (CCDF Discretionary = $4,307,739; ARP Stabilization" = $715,000; CRRSA-5232,000; PDG=$18,340) GAE funds shall be split among other Early Childhood Council (ECC) vendors. See Exhibit F, Section 12. SFY25 ARP Discretionary- $20,956  ARPI Discretionary- $20,956  $20,956  vii. Federal award project description:  CCDF Discretionary- - Child Care and Development Fund;  ARPI Discretionary- Child Care Supplemental Discretionary Funds, American Rescue Plan Act, ARP: Stabilization Child Care Stabilization Funds, American Rescue Plan Act, Child Care and CRRSA - Coronavirus Response and Relief Supplemental Act (CRRSA), Child Care Development  Child Care and Developmental, Fund; Developmental. Fund; Block Grant;  PDG- Colorado Preschool Development Grant;  vii. The name of the Federal awarding agency isl Department of Health and Human Services, Administration for Children and Families; the name of the pass-through entity is the State of Colorado, Department of Early  Supplemental Provisions forl Federal. Awards  Page2of11  V2(07-08-2022)    Childhood (CDEC); and the contact information for the awarding official isl Karen Enboden, Manager, Earlyl Learning Access and Quality, 1575 Sherman Street, 1st Floor, Denver, CO 80203,  Karalabodmgntieas 303.866.5014; ix. The Catalog ofl Federal Domestic. Assistance (CFDA) number is 1990, and dollar amount is $14,220,255; and dollar amount is $178,553,758; and dollar amount is $286,156,175; amount is $119,294,226; amounti is $26,056,722; This awardi is not for research & development;  CCDF Discretionary - CFDA 93.575, namei is Child Care: and Development Block Grant Act of ARPI Discretionary CFDA 93.575, name is Child Care and Development Block Grant Act of1990, ARP Stabilization - CFDA 93.575, name is Child Care and Development Block Grant Act of1 1990, CRRSA- - CFDA 93.575, name is Coronavirus Response and Relief Supplemental. Act, and dollar PDG- CFDA 93.434, name: is Child Care and Development Block Grant Act of1990, and dollar  xi. Thei indirect cost1 rate for the Federal award (including ift the de minimis rate is charged per 2 CFR $200.414 Indirect (F&A) costs) is pre-determined based upon the State of Colorado and CDEC cost allocation plan. 2) All requirements imposed by CDEC on Subrecipient so that the Federal award is used in accordance with Federal statutes, regulations, and the terms and conditions oft the Federal award, are stated in the General Provisions, Exhibit 3) Any additional requirements that CDEC imposes on Subrecipient in order for CDEC to meeti its owni responsibility to thel Federal awarding agency, includingi identification of any required financial and performance reports, are statedi in the General Provisions, Exhibit A - Statement of Work and Exhibit F- Additional Provisions.. 5) Subrecipient must permit CDEC and auditors tol have access to Subrecipient's records and financial statements as necessary for CDEC to meet the: requirements of2 CFR $200.331 Requirements for pass-through entities, SS 200.300 Statutory and National Policy Requirements through $200.309 Period of performance, and Subpart F--Audit 6) The appropriate terms and conditions concerning closeout oft the subaward are listed in Section 16oft this Exhibit and the General Provisions, Exhibit A - Statement of Work and Exhibit F- Additional Provisions.. 7) Performance and Final Status. Subrecipient: shall submit all: financial, performance, and other reports to CDEC no later than 30 calendar days after thej period of performance end date or sooner termination oft this Contract containing ane evaluation and review of Subrecipient's performance and thei final status of Subrecipient's obligations hereunder.  A- Statement of Work and Exhibit F - Additional Provisions.  4) Subrecipient's: approved indirect cost ratei is the CDEC negotiated rate of 0%.  Requirements oft this Part.  8) Matching Funds  Ifal box below is checked, the accompanying provision applies.  Subrecipient is not required toj provide matching funds.  ii.  Subrecipient shall provide matching funds as statedi in N/A. Subrecipient shall have raised the full amount of matching funds prior tot the Effective Date and shall report to CDEC regarding the status of such funds upon request. Subrecipient's obligation toj pay all or any part of any matching funds, whether direct or contingent, only extends toi funds duly and] lawfully appropriated: for thej purposes of this Contract byt the authorized representatives of the Subrecipient and paid into the Subrecipient'st treasury or bank account. Subrecipient represents to CDEC that the amount designated as matching funds has been legally appropriated fort the purposes of this Contract by its authorized representatives and paidi into its treasury or bank account. Subrecipient does not byt this Contract irrevocably pledge present cash reserves for payments ini future fiscal years, and this Contracti is not intended to create a multiple-fiscal year debt ofthe Subrecipient. Subrecipient  Supplementall Provisions forl Federal Awards  Page3of11  V2(07-08-2022)    shall not pay or be liable for any claimed interest, late charges, fees, taxes or penalties of any nature, except as  required by Subrecipient's laws or policies.  . 1 DEFINITIONS.  1.1. For the purposes of these Federal Provisions, the following terms shall have the meanings ascribed to them 1.1.1. "Award" means an award of Federal financial assistance, and the Contract setting forth the terms and conditions of that financial assistance, that a non-Federal Entity receives or administers.  below.  1.1.1.1.1. 1.1.1.1.2. 1.1.1.1.3. 1.1.1.1.4. 3710); 1.1.1.1.5. 1.1.1.1.6. 1.1.1.1.7. 1.1.1.1.8. 1.1.1.1.9.  Awards may be in thei form of:  Grants; Contracts;  Cooperative Contracts, which do not include cooperative research and development Contracts (CRDA): pursuant to the Federal Technology Transfer Act of 1986, as amended (15U.S.C.  Loans; Loan Guarantees; Subsidies; Insurance; Food commodities;  1.1.1.1.10. Direct appropriations; non-Federal Entities. other source posted byt the OMB.  1.1.1.1.11. Assessed and voluntary contributions; and  1.1.1.1.12. Other financial assistance transactions that authorize the expenditure of Federal funds by 1.1.1.1.13. Any otheri items specified by OMB inj policy memoranda available at the OMB website or  1.1.1.2. 1.1.1.2.1. 1.1.1.2.2. iscalled a grant; 1.1.1.2.3. 1.1.1.2.4.  Award does not include:  Technical assistance, which provides services in lieu of money;  At transfer oft title tol Federally-owned property providedi in lieu ofmoney; eveni ift the award Any award funded in whole or in part with Recovery funds, as defined in section 1512of  Any award classified for security purposes; or  the American Recovery and Reinvestment Act (ARRA)of2009 (Public Law 111-5).  1.1.2. "Contract" means the Contract to which these Federal Provisions are attached andi includes all. Award types 1.1.3. "Contractor" means the party or parties to a Contract funded, in whole or in part, with Federal financial assistance, other than the Prime Recipient, and includes grantees, subgrantees, Subrecipients, and borrowers. For purposes ofTransparency. Act reporting, Contractor does not include Vendors. 1.1.4. "Data Universal Numbering System (DUNS) Number" means the nine-digit number established and assigned by Dun and Bradstreet, Inc. to uniquely identify al business entity. Dun and Bradstreet's website  ins ofthis Exhibit.  may be found at: P/RApvahib.wpalom  1.1.5. "Entity" means: 1.1.5.1. Supplemental Provisions for Federal. Awards  Ifthe source of funding is a Grant:  Page 4of11  V2( (07-08-2022)    1.1.5.1.1, aN Non-Federal Entity; 1.1.5.1.2. a foreign public entity; 1.1.5.1.3. af foreign organization; 1.1.5.1.4. ar non-profit organization;  1.1.5.1.5. ac domestic for-profit organization (for 2 CFR parts 25 and 170 only); 1.1.5.1.6. ai foreign non-profit organization (only for 20 CFR part 170) only); 1.1.5.1.7. al Federal agency, but only as a Subrecipient under an Award or Subaward to a 1.1.5.1.8. ai foreign for-profit organization (for 2 CFR part 170 only). 1.1.5.2.1. all oft the following as defined at 2 CFR part 25, subpart C;  non-Federal entity (or2CFR 200.1); or Ifthes source of funding is not a Grant:  1.1.5.2.  1.1.5.2.2. A governmental organization, whichi is a State, local government, or Indian Tribe;  1.1.5.3. af foreign public entity;  1.1.5.4. a domestic or foreign non-profit organization; 1.1.5.5. ac domestic or foreign for-profit organization; and  1.1.5.6. a Federal agency, but only a Subrecipient under an Award or Subaward to a non-  Federal entity.  1.1.6. "Executive" means an officer, managing partner or any other employee in al management position. 1.1.7. If the source of funding is a Grant, "Federal Awarding Agency" means a Federal agency providing a Federal Award to al Recipient as described in 2 CFR 200.1.Ifthe: source ofi funding is nota a Grant, "Federal Award dentification Number (FAIN)" means an Award number assigned by al Federal agency to al Prime 1.1.8. "FFATA" means thel Federal Funding Accountability: and' Transparency. Act of2006 (Public Law 109-282), as amended by $6202 ofPublicl Law 110-252. FFATA, as amended, alsoi isI referred tos ast the "Transparency 1.1.9. "Federal Provisions" means these Federal Provisions subject to the Transparency Act and Uniform Guidance, as may be revised pursuant to ongoing guidance from the relevant Federal or State of Colorado 1.1.10. Ifthes source of funding isa Grant, "Grant" as used herein is the Contract to which these Federal Provisions 1.1.11. "Grantee" means the party or parties identified as suchi in the Grant to which these Federal Provisions are 1.1.12. "Non-Federal Entity means a State, local government, Indian tribe, institution of higher education, or nonprofit organization that carries out al Federal Award as a Recipient or a Subrecipient. 1.1.13. "Nonprofit Organization" means any corporation, trust, association, cooperative, or other organization, not  Recipient. Act."  agency ori institutions ofhigher education.  are attached.  attached: ift the source of funding is a Grant.  including IHEs, that:  1.1.13.1. Is operated primarily for scientific, educational, service, charitable, or similar purposes in the 1.1.13.3. Uses net proceeds to maintain, improve, or expand the operations oft the organization. 1.1.14. "OMB" means thel Executive Office of the President, Office of Management and! Budget.  public interest;  1.1.13.2. Is not organized primarily for profit; and  Supplemental Provisions for Federal Awards  Page5of11  V2 (07-08-2022)    1.1.15. "Pass-through Entity" means ai non-Federal Entity that provides a Subaward to a Subrecipient to carry out 1.1.16. "Prime Recipient" means a Colorado State agency ori institution ofhigher education that receives an Award, or, ofthe source of funding is a Granti iti is that agency or institution identified as the Grantor in the Grant 1.1.17. "Subaward" means an award by al Prime Recipient to a Subrecipient funded in whole ori inj part byal Federal Award. The terms and conditions of the Federal Award flow down to the Subaward unless thet terms and conditions of the Federal Award specifically indicate otherwise in accordance with 2 CFR 200.101 or 2 CFR200.38, as applicable. Thet term doest noti include payments tos a contractor or payments to ani individual 1.1.18. "Subrecipient", or, ifthe source offundingi isa Grant, "Subgrantee" means anon-Federall Entity (ora al Federal agency under an Award or Subaward to a non-Federal Entity) receiving Federal funds through a Prime Recipient to support the performance of the Federal project or program for which the Federal funds were awarded.. A Subrecipient: iss subject to thet terms and conditions oft thel Federal. Awardi to1 thel Primel Recipient, including program compliance requirements. The term' "Subrecipient" includes and may be referred to as Subgrantee. The term does noti include ani individual whoi is a beneficiary ofai federal program. 1.1.19. "Subrecipient. Parent DUNS) Number" means thes subrecipient parent organization' 's9 9-digit Data Universal Numbering System (DUNS) number that appears in the subrecipient's System for Award Management 1.1.20. "System for Award Management (SAM)" means the Federal repository into which an Entity must enter the information required under the' Transparency Act, which may be found atl htplwww.sam.gov. 1.1.21. "Total Compensation". means the cash and noncash dollar value earned by an Executive during thel Prime Recipient's or Subrecipient's preceding fiscal year (see 48 CFR 52.204-10, as prescribed in 48 CFR 1.1.21.2. Awards of stock, stock options, and stock appreciation rights, using the dollar amount  part ofal Federal program.  to which these Federal Provisions are attached.  thati is al beneficiary ofal Federal program.  (SAM) profile, ifapplicable.  4.1403(a), as applicable) andi includes the following:  1.1.21.1.  Salary and bonus;  recognized for financial statement reporting purposes with respect to the fiscal year in accordance with the Statement of Financial Accounting Standards No. 123 (Revised 2005) hospitalization or medical reimbursement plans that do not discriminate in favor of Executives Change in present value of defined' benefit and actuarial pension plans; Above-market earnings on deferred compensation which is not tax-qualified; termination payments, value of life insurance paid on behalf of the employee, perquisites or  (FAS 123R), Shared Based Payments;  1.1.21.3. Earings for services under non-equity incentive plans, not including group life, health,  and are available generally to all salaried employees;  1.1.21.4. 1.1.21.5.  1.1.21.6. Other compensation, if the aggregate value of all such other compensation (e.g., severance,  property): fort the Executive exceeds $10,000.  1.1.22. "Transparency. Act" means thel Federal Funding Accountability and Transparency. Act of2006 (Public Law 109-282), as amended by $6202 of Public Law 110-252. The' Transparency Act may also be referred to as 1.1.23. "Uniform Guidance" means the Office ofManagement: and] Budget Uniform Administrative Requirements, Cost Principles, and Audit Requirements: forl Federal. Awards, which, unless the source off fandingisaGrant, supersedes requirements from OMB Circulars A-21, A-87, A-110, and A-122, OMB Circulars A-89,A- 102, and A-133, and the guidance in Circular A-50 on Single Audit Act follow-up. The terms and conditions oft the Uniform Guidance flow down to Awards to Subrecipients unless the Uniform Guidance  FFATA.  or the terms and conditions oft the Federal Award specifically indicate otherwise.  Supplemental: Provisions for Federal Awards  Page6 6of11  V2( (07-08-2022)    1.1.24. "Vendor" means a dealer, distributor, merchant or others seller providing property or services required fora project or program funded by an Award. A Vendor is not a Prime Recipient or a Subrecipient and is not subject to the terms and conditions of the Federal award. Program compliance requirements do not pass  through to a Vendor.  2. COMPLIANCE.  2.1. Contractor/Grantee shall comply with all applicable provisions of the Transparency Act and the regulations issued pursuant thereto, all applicable provisions of the Uniform Guidance, including, but not limited to, all applicable Federal Laws and regulations required by this Federal Award. Any revisions to such provisions or regulations shall automatically become aj part of these Federal Provisions, without the necessity of either party executing any further instrument. The State of Colorado, ati its discretion, may provide written notification to Contractor/Grantee of such revisions, buts such notice shall notl be a condition precedent to the effectiveness of  such revisions. REQUIREMENTS.  3. SYSTEM FOR. AWARD MANAGEMENT (SAM) AND DATA UNIVERSAL NUMBERING: SYSTEM (DUNS) 3.1. SAM. Contractor/Grantee shall maintain the currency ofi its information in SAM until the Contractor/Grantee submits the final finançial report required under the Award or receives final payment, whichever is later. Contractor/Grantee shall review and update SAMi information at least annually after the initial registration, and 3.2. DUNS. Contractor/Grantee shall provide its DUNS number to its Prime Recipient, and shall update Contractor's/Grantee's information inl Dun & Bradstreet, Inc. at least annually after thei initial registration, and  more frequently ifrequired by changes in its information.  morei frequently ifrequired by changes in Contractor's/Grantee'sinformation.  4. TOTAL COMPENSATION.  4.1. Contractor/Grantee shall include Total Compensation in SAM for each of its five most highly compensated 4.1.1. The total Federal funding authorized to date under the Award is $30,000 or more ifi the source of funding 4.1.2.1. 80% or more ofi its annual gross revenues from Federal procurement contracts and subcontracts and/or Federal financial assistance Awards or Subawards subject to the' Transparency Act; and 4.1.2.2. $30,000,000 or more in annual gross revenues from Federal procurement contracts and subcontracts and/or Federal financial assistance Awards or Subawards subject to the' Transparency Act ift the source off funding is a Grant or otherwise $25,000,000 or more in annual gross revenues from Federal procurement contracts and subcontracts and/or Federal financial assistance Awards or Subawards subject to the Transparency Acti ift the source of funding is not a Grant; and 4.1.2.3. The public does not! have access to information. about the compensation ofsuch] Executives through periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15 U.S.C. 78m(a), 78o(d)or$6104 of thel Internal Revenue Code of1986.  Executives for the preceding fiscal year if:  isa Grant, or otherwise $25,000 or more ift the source of funding is not a Grant; and  4.1.2. Int thej preceding fiscal year, Contractor/Grantee. received:  REPORTING.  5.1. IfC Contractor/Grantee is a Subrecipient of the Award pursuant to the Transparency Act, Grantee shall report data elements to SAM and tot thel Primel Recipient as required ini this Exhibit. No direct payment shall be made to Grantee for providing any reports required under these Federal Provisions and the cost of producing such reports shall bei included in the Contract/Grant price. The reporting requirements in this Exhibit are based on guidance from the US Office ofManagement and Budget (OMB), and as such are subject to change at any time by OMB. Any such changes shall be automatically incorporated into this Contract/Grant: ands shall become part  of Contractor'sGrantee's: obligations under this Contract/Grant.  Supplemental Provisions for Federal. Awards  Page7of11  V2( (07-08-2022)    5. EFFECTIVE DATE. ANDI DOLLAR THRESHOLD: FORI REPORTING.  6.1. Ifthe source of funding is a Grant, Reporting requirements in $8 below apply to new. Awards as of October 1, 2010, if the initial award is $30,000 or more. If the initial Award is below $30,000 but subsequent Award modifications resulti in at total Award of$30,000 or more, the Award is subject to the reporting requirements: as of the date the. Award exceeds $30,000. Ifthe initial Award is $30,000 or more, but funding is subsequently de-obligated such that the total award amount falls below $30,000, the Award shall continue to be subject to 6.2. Ifthes source of funding is not a Grant, Reporting requirements in $81 below apply to new Awards as ofOctober 1,2010, if thei initial award is $25,000 or more. Ifthei initial Award is below $25,0001 but subsequent Award modifications resulti in a total Award of$25,000 or more, the Awardi is subject to the reporting requirements: as of the date the Award exceeds $25,000. Ift the initial. Award is $25,000 or more, but funding is subsequently de-obligated such that the total award amount falls below $25,000, the Award shall continue to be subject to 6.3. Thep procurement standards in $81 below are applicable toi new. Awards madel by Prime Recipient as ofDecember 26, 2015. The standards set forth in $10 below are appliçable to audits of fiscal years beginning on or after  ther reporting requirements.  ther reporting requirements. December 26, 2014.  7. SUBRECIPIENT REPORTING REQUIREMENTS.  7.1. rContractor/drantee is a Subrecipient, Contractor/Grantee shall report as set forth below.  7.1.1. To SAM. A Subrecipient shall register in SAM and report the following data elements in SAMfor each Federal Award Identification Number (FAIN) assigned by al Federal agency to a Prime Recipient no later 7.1.1.2. Subrecipient DUNS Number if more than one electronic funds transfer (EFT) account; 7.1.1.4. Subrecipient's address, including: Street Address, City, State, Country, Zip (+4 4 if source of 7.1.1.5. Subrecipient's top 5 most highly compensated Executives ift the criteria in $4 above are met; 7.1.1.6. Subrecipient's? Total Compensation oftop 5 most highly compensated: Executives ift the criteria 7.1.2. To Prime Recipient. A Subrecipient shall report to its Prime Recipient, upon the effective date of the  than the end oft the month following the month in which the Subaward was made:  7.1.1.1. Subrecipient DUNSI Number;  7.1.1.3. Subrecipient parent's organization DUNS Number;  funding is a Grant or as otherwise directed per SAM directives for proper reporting), and  Congressional District; and in $4 above met.  Contract/Grant, the following data elements: 7.1.2.1. Subrecipient'sI DUNS Number as registered in SAM.  7.1.2.2. Primary Placec ofPerformance Information, including: Street Address, City, State, Country, Zip  code + 4, and Congressional District.  8. PROCUREMENT STANDARDS.  8.1. Procurement Procedures. A Subrecipient shall use its own documented procurement procedures which reflect applicable State, local, and' Tribal laws and applicable regulations, provided that the procurements conform to applicable Federal law and the standards identified in the Uniform Guidance, including without limitation, 2  CFR 200.318 through 200.327 thereof.  Supplemental Provisions for Federal Awards  Page 8of11  V2/(07-08-2022)    8.2. Ift the source of funding is a Grant: Domestic preference for procurements (2 CFR 200.322). As appropriate and to the extent consistent with law, the non-Federal entity should, to the greatest extent practicable under a Federal award, provide a preference for the purchase, acquisition, or use of goods, products, or materials produced in the United States (including but not limited to iron, aluminum, steel, cement, and other manufactured products). The requirements of this section must be included in all subawards including all 8.3. Procurement ofl Recovered Materials. Ifa Subrecipienti is a State Agency ora an agency ofaj political subdivision oft the State, its contractors must comply with section 6002 oft the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act. The requirements of Section 6002 include procuring only items designated in guidelines of the Environmental Protection Agency (EPA) at 40 CFR part 247, that contain the highest percentage of recovered materials practicable, consistent with maintaining a satisfactory level of competition, where thej purchase price ofthei item exceeds $10,000 or the value oft the quantity acquired during the preceding fiscal year exceeded $10,000; procuring solid waste management services in a manner that maximizes energy andi resourcei recovery; ande establishing an affirmative procurement program forp procurement  contracts and purchase orders for work or products under this award.  ofrecovered materials identified ini the EPA guidelines.  9. ACCESSTORECORDS.  9.1. A Subrecipient shall permit Recipient/Prime Recipient andi its auditors tol have access to Subrecipient'srecords: and financial statements as necessary for Recipient to meet the requirements of2 CFR 200.311-200.332 (Requirements for pass-through entities), 20 CFR: 200.300 (Statutory and national policy requirements) through 2CFR:200.309 (Period of performance), and Subpart F-Audit Requirements of the Uniform Guidance. 10.1. Ifa Subrecipient expends $750,000 or more in Federal Awards during the Subrecipient's fiscal year, the Subrecipient shall procure or arrange for a single or program-specific audit conducted for that year in accordançe with thej provisions of Subpart F-Audit Requirements of the Uniform Guidance, issued pursuant to 10.1.1. Election. A Subrecipient shalll have as single: audit conducted in accordance with Uniform Guidance 2CFR 200.514 (Scope of audit), except when it elects to have aj program-specific audit conducted in accordance with 2 CFR 200.507 (Program-specific audits). The Subrecipient may elect to have aj program-spccihc audit if Subrecipient expends Federal Awards under only one Federal program (excluding research and development) and the Federal program's statutes, regulations, or the terms and conditions of the Federal award do not: require a financial statement audit of Prime Recipient. Aj program-specitic audit may not be elected for research and development unless all of the Federal Awards expended were received from 10.1.2. Exemption. Ifa Subrecipient expends less than $750,000 in Federal Awards during its fiscal year, the Subrecipient shall be exempt from Federal audit requirements for that year, except as noted in 2 CFR 200.503 (Relation to other audit requirements), but records shall be available for review or audit by appropriate officials of thel Federal agency, the State, and the Government Accountability Office. 10.1.3. Subrecipient Compliance Responsibility. A Subrecipient shall procure or otherwise arrange for the audit required by Subpart F of the Uniform Guidance and ensure it is properly performed and submitted when due ins accordance with the Uniform Guidance. Subrecipient shall prepare appropriate financial statements, including the schedule of expenditures of Federal awards in accordance with 2 CFR 200.510 (Financial statements) and provide the auditor with access to personnel, accounts, books, records, supporting documentation, and other information as needed for the auditor to perform the audit required by Uniform  10. SINGLE AUDIT REQUIREMENTS.  the Single Audit. Act Amendments of1 1996, (31U.S.C. 7501-7507). 2CFR200.501.  Recipient and Recipient approves in advance a program-specific audit.  Guidance Subpart F-Audit Requirements.  11. CONIKACTIGRANT PROVISIONS FOR SUBRECEPIENT CONTRACTS.  11.1. In addition to other provisions required by the Federal Awarding Agency or the Prime Recipient, Contractors/Grantees that are Subrecipients shall comply with the following provisions. Subrecipients shall include all of the following applicable provisions in all subcontracts entered into by it pursuant to this  Contract/Grant. Supplemental! Provisions for Federal Awards  Page9of11  V2( (07-08-2022)    11.1.1. [Applicable to federally assisted construction contracts.] Equal Employment Opportunity. Except as otherwise provided under 41 CFR Part 60, all contracts that meet the definition of "federally assisted construction contract" in 410 CFR Part 60-1.3 shalli include the equal opportunity clause provided under 41 CFR 60-1.4(b), in accordance with Executive Order 11246, "Equal Employment Opportunity" (30 FR 12319, 12935,3CFRI Part, 1964-1965 Comp.p. 339), as amended byl Executive Order 11375, "Amending Executive Order 11246 Relating to Equal Employment Opportunity," and implementing regulations at 41 CFR part 60, Office of Federal Contract Compliance Programs, Equal Employment Opportunity, 11.1.2. [Applicable to on-site employees working on govemment-funded construction, alteration and repair 11.1.3. Rights tol Inventions Madel Undera a contract/grant or agreement. Ifthel Federal. Award meets the definition of "funding agreement"! funding Contract" under 37 CFR 401.2 (a) and the Prime Recipient or Subrecipient wishes to enter into a contract with a small business firm or nonprofit organization regarding the substitution of parties, assignment or performance of experimental, developmental, or research work under that' funding agreement,"l-funding Contract", the Primel Recipient or Subrecipienti must comply with the requirements of 37 CFR Part 401, "Rights tol Inventions Made by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative. Agreements,"and: anyi implementing 11.1.4. Clean Air Act (42 U.S.C. 7401-7671q.) and the Federal Water Pollution Control Act (33 U.S.C. 1251- 1387), as amended. Contracts and subgrants of amounts in excess of$ $150,000 must contain aj provision that requires the non-Federal awardee(s) to agree to comply with all applicable standards, orders or regulations issued pursuant to the Clean Air Act (42 U.S.C. 7401-7671q) and the Federal Water Pollution Control Act as amended (33 U.S.C. 1251-1387). Violations must be reported to the Federal Awarding notl be made to parties listed on the govemment wide exclusions in the System for Awardl Management (SAM), in accordance with the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR part 1986 Comp., p. 189) and 12689 (3 CFR part 1989 Comp., P. 235), "Debarment and Suspension." SAM Exclusions contains the names of] parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared 11.1.6. Byrd Anti-Lobbying. Amendment (31 U.S.C. 1352). Contractors that apply or bidi for an award exceeding $100,000: must filet ther required certification. Each tier certifies to the tier above that it will not and has not used Federal appropriated: funds to pay: any person or organization fori influencing or attempting toi influence an officer or employee of any agency, a member of Congress, officer or employee of Congress, or an employee ofa member of Congress in connection with obtaining any Federal contract, grant or any other award covered by 31 U.S.C. 1352. Each tier must also disclose any lobbying with non-Federal funds that takes place in connection with obtaining any Federal award. Such disclosures are forwarded from tier to 11.1.7. Never contract with the enemy (2 CFR 200.215). Federal awarding agencies and recipients are subject to the regulations implementing "Never contract with the enemy" in2 CFR part 183. The regulations in 2 CFR part 183 affect covered contracts, grants and cooperative agreements that are expected to exceed $50,000 within the period of performance, are performed outside the United States and its territories, and are in support ofa contingency operation in which members of the Armed Forces are actively engaged in 11.1.8. Prohibition on certain telcommunications and video surveillance services or equipment (2 CFR 200.216). Grantee is prohibited from obligating or expending loan or grant funds on certain telecommunications and  Department ofI Labor.  project:]Davis-Bacon. Act. Davis-Bacon Act, as amended (40U.S.C. 3141-3148).  regulations issued by thel Federal Awarding Agency.  Agency andt the Regional Office ofthel Environmental: Protection Agency (EPA).  11.1.5. Debarment and Suspension (Executive Orders 12549 and 12689). A contract award (see 2 CFR 180.220) must  ineligible under statutory or regulatory authority other than Executive Order 12549.  tier up to thei non-Federal award.  hostilities.  video surveillance services or equipment pursuant to2 2 CFR: 200.216.  12. CERTIFICATIONS.  Supplemental Provisions for Federal Awards  Page 10of11  V2/(07-08-2022)    12.1. Unless prohibited by Federal statutes or regulations, Recipient/Prime Recipient may require Subrecipient to submit certifications and representations: required by Federal statutes or regulations on an annual basis. 2CFR 200.208. Submission may be required more frequentlyif ifSubrecipient: fails toi meeta a requirement ofthel Federal award. Subrecipient shall certify in writing to the! State at the end oft the Award that the project or activity was completed or1 thel level ofeffort was expended. 2CFR:200.20103). Ifthe required level ofactivity or effort was  not carried out, the amount of the Award must be adjusted.  13. EXEMPTIONS.  13.1. Thesel Federal Provisions do not apply to ani individual who receives an Award as ai natural person, unrelated to 13.2. A Contractor/Grantee with gross income from all sources of less than $300,000 in the previous tax year is exempt from thei requirements to report Subawards and the Total Compensation ofits most! highly compensated  any business or non-profit organization he or shei may own or operate inl his or her name.  Executives.  14. EVENT OF DEFAULT. AND TERMINATION.  14.1. Failure to comply with these Federal Provisions shall constitute an event of default under the Contract/Grant and the State of Colorado may terminate the Contract/Grant upon 30 days prior written notice if the default remains uncured five calendar days following thet termination of the 30-day notice period. This remedy willl be ina addition to any other remedy available tot the State ofColorado under the Contract/Grant, atl law or in equity. 14.2. Termination (2 CFR 200.340). Thel Federal. Award may bet terminated in whole ori in part as follows: 14.2.1. By the Federal Awarding Agency or Pass-through Entity, ifal Non-Federal Entity fails to comply with the 14.2.2. Byt thel Federal awarding agency orl Pass-through Entity,t to the greatest extent authorized byl law, ifan award 14.2.3. By the Federal awarding agency or Pass-through Entity with the consent of the Non-Federal Entity, in which case thei two parties must agree upon the termination conditions, including the effective date and, in 14.2.4. By the Non-Federal Entity upon sending to the Federal Awarding Agency or Pass-through Entity written notification setting forth the reasons for such termination, the effective date, and, in the case of partial termination, thep portion to bet terminated. However, ifthel Federal. Awarding Agency or Pass-through Entity determines in the case ofp partial termination that thei reduced or modified portion oft the Federal Award or Subaward will not accomplish the purposes for which the Federal Award was made, thel Federal Awarding 14.2.5. By thel Federal Awarding Agency orl Pass-through Entity pursuant to termination provisions includedi int the  terms and conditions of al Federal. Award;  no longer effectuates the program goals or agency priorities; the case of partial termination, thej portion to be terminated;  Agency or Pass-through Entity may terminate the Federal Award ini its entirety; or  Federal Award.  EXHIBIT END  Supplemental: Provisions for Federal. Awards  Page 11 of11  V2 (07-08-2022)    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested: 6-13-2023 Submitter: Meagan Hillman, PCPHE Director  Submitted to the County Administration Office on: 05/22/2023 Return Originals to: Meagan Hillman PCPHE Director Number of originals to return to Submitter: 2  Contract Due Date: June 30  Item Title/Recommended Board Action:  Consider approval of Master Task Order Contract No. 23 FAA 00042, Task Order No. 2024*0447 for Prowers County Public Health to provide environmental health services, effective 7-1-2023 to 6-30-2028, funding in the amount of $30,000 and Authorizing Meagan Hillman, Public Health Justification or Background: This is annual Environmental Health funding from CDPHE.  Director to execute the document electronically.  Fiscal Impact: This item is budgeted in the following account code:  County: $  Federal: $  State: $  Other: $  Approved by the County Attorney on: Additional Approvals (ifrequired):    DocuSign Envelope ID: FEDC9BF0-46AF4560-A124-5FDD4091B401  TASK ORDER  State Agency State ofColorado for theL use & benefit oft the Department of Public! Health andl Environment 4300 Cherry Creek Drive South Denver CO 80246  Contractor Board ofCounty Commissioners of Prowers County (a political subdivision of thes state of Colorado) 301 South Main Street, #215 Lamar CO 81052 for the use and benefit oft the Prowers County Public Health 1001 South Main Street Lamar CO 81052-3838 July 1,2023  Master Task Order Contract Number 231 FAA 00042 Task Order Number 2024*0447 Task Order Maximum Amount Initial Term State Fiscal Year 2024 Total for All Statel Fiscal Years Pricing/Funding Price Structure: Cost) Reimbursement Contractor Shall Invoice: Quarterly Funding Source: State State Representative Sean Scott Deputy Director Division of] Environmental Health and Environment Colorado Department of Public Health and Environment 4300 Cherry Creek Drive South Denver, CO80246 Seanscot(Qstatecous Exhibits and Order of Precedence Exhibit B Statement of Work Exhibit CE Budget Contract Purpose  Task Order Performance Beginning Date The latero of the Task Order Effective Date or  Task Order Expiration Date June 30, 2028  $30,000.00 $30,000.00  Except as stated in $2.D., the total duration ofthis Contract, including the exercise of any options to extend, shall not exceed 5 years fromi its Performance Authority to enteri intot this Contract exists in: C.R.S. 25-1.5-101 - C.R.S.25-1.5-113 Law Specified Vendor Statute (ifany): N/A Procurement Method: Other Solicitation Number (if any): Enter Solicitation # Contractor Representative Meagan Hillman Prowers County Public Health 1001 Southl Main Street Lamar CO 81052-3838 Almamepowesounyne  Beginning Date. Miscellaneous:  $30,000.00  The following Exhibits and attachments are included with this Contract:  Top provide environmental health services to achieve the uniform statewide administration, implementation and enforcement of standards andr rules established by CDPHE: for retail food establishments, child care facilities ands schools. Ina accordance with $4.B oft the Master" Task Order Contract referenced above, Contractor shall complete the following  Project:  1.P PROJECT DESCRIPTION Task Order Number: 2024*0447  Page 1of3  Version 02.24.2022    DocuSign Envelope ID: EDC9BF0-46AF-4560-A124-5FDD4C91B401  Contractor shall complete the Project described in Exhibit B Statement of Work (SOW) that is attached hereto and incorporated! herein ("the SOW"). Allt terminology used int this Task Order and the Statement of Work shall bei interpreted in accordance with the Master Task Order Contract unless specifically defined differently in this Task Order. The Statement of Work and Budget are incorporated herein, made aj part hereof and attached hereto asl Exhibit B Statement The State shall pay Contractor the amounts shown in] Exhibit C- Budget thati is attached hereto andi incorporated herein, ina accordance with the requirements oft the Statement of Work and thel Master Task Order Contract. The State shall not make any payment for a State Fiscal Year that exceeds the Task Order Maximum Amount shown above for that State Contractor shall complete all Work on the Project described in this Task Order by the Task Order Expiration Dates stated above. Contractor shall not perform any Work described in the Statement of Work prior tot the Task Order Performance Thel Effective: Date ofthis" Task Order is upon: approval oft the State Controller or July 1, 2023, whichever is later.  ofWork and Exhibit C- Budget. 2. PAYMENT  Fiscal Year. 3. PERFORMANCE PERIOD  Beginning Date or after the Task Order Expiration Date stated above.  4. TASK ORDER EFFECTIVEDATE:  Task Order Number: 2024*0447  Page 2 of3  Version 02.24.2022    DocuSign Envelope ID: FEDC9BF0-46AF-4560-A124-5FDD4C91B401  THE PARTIES HERETO HAVE EXECUTED THIS CONTRACT Each person signing this Contract represents and warrants that he or she is duly authorized to execute this Contract and to bind the Party authorizing his orl her signature.  CONTRACTOR Board of County Commissioners ofProwers County (ap political subdivision oft the state of Colorado) for the use and benefit ofthe Prowers County Public Health By: Signature  STATE OF COLORADO Jared S.1 Polis, Governor Colorado Department of] Public) Health and Environment Jill Hunsaker Ryan, MPH, Executive Director  By: Signature  Meagan Hillman Director  Name ofl Person Signing for Contractor Title of Person Signing for Contractor  Name of Executive Director Delegate Title ofl Executive Director Delegate  Date:  Date:  In accordance with $24-30-202, C.R.S., this Option is not valid until signed and dated below by the State Controller or an  authorized delegate. STATE CONTROLLER Robert. Jaros, CPA, MBA, JD  By: Signature  Name of State Controller Delegate Title of State Controller Delegate  Effective! Date:  --Signature Page End--  Task Order Number: 2024*0447  Page 3of3  Version 02.24.2022    DocuSign Envelope ID: EDC9BF0-46AF-4560-A124-5FDD4C91B401  EXHIBITB  STATEMENT OF WORK To Original Contract Number 2024*0447  These provisions are tol be read and interpreted inc conjunction with the provisions of the contract specified above.  Project Description:  Local public healtha agencies are essential tot thej provision ofc quality and comprehensive publicl health: services throughoutt the: state and are critical partners witht the Colorado Department ofPublic] Health and] Environment in maintaining as strong public health system. Each local public health agency shall assure the provision of Corel Public Health Services within their jurisdiction. Thes scope oft the provision ofe each Corel Public Health Service is determined att the local level, andi may differ across agencies based on community needs, priorities, funding and capacity. This project willi inspect anda assure regulatory compliance! in retail foodestablishments, child care facilities ands schools. The activities and deliverables for this project cannot be delegated by the Contractor to third party(ies), i.e. subcontracted, without written approval from the State.  II. Definitions:  1. CDPHE: Colorado Department of Public Health and Environment 2. DEHS: Division of] Environmental Health and Sustainability 3. HACCP: Hazard Analysis Critical Control Points aHACCP-based critical item inspection.  4. Intervention: is considered. a routine inspection and can include onsite training, announced inspection, or  5. VNRFPS: Voluntary National Retail Food Regulatory Program Standards  II. Work) Plan:  Goal #1: Top protect and improve Colorado's environment andl human health through education, collaboration and compliance Objective? #1: No later than the expiration date of this contract, the Contractor shall provide environmental health services to  assurance in retail foode establishments, child care facilities and schools.  achieve the uniform statewide administration, implementation and enforcement ofs standards and rules established by the CDPHE for retail food establishments, child care facilities and schools.  The Contractor shall conduct regulatory inspections of retail food establishments in accordance 1. The Contractor shall conduct on-site routine inspections of each retail food establishment ataf frequency determined by ai risk-based: methodology approved by the State or twice per yeara and enter those inspection results into the Contractor's digital database or the State's digital database no later than two (2) working days after the activity was completed. a. The Contractor shall have a system for determining and tracking the next inspection dates due in such a manner that allows for the Contractor to easily determine any past due inspections. As such, the Contractor shall not havei inspections that are more than b. Ifextenuating circumstances cause the Contractor to be more than 90 days past due, the Contractor shall notify the Statei in writing oft the extenuating circumstançes. 2. The Contractor shall conduct interventions andr re-inspections for those retail food establishments that, through inspection findings, are identified as requiring re-inspections ort that require immediate closure and enter those inspection results into the Contractor's digital database or the State's digital database no later than two (2) working days after the  Primary Activity #1  withs state laws, regulations and standards.  Sub-Activities #1  90 days past due.  Page lof7  Original Contract Number: 2024*0447  Ver. 01.11.19    DocuSign Envelope ID: EDC9BF0-46AF-4560-A124-5FDD4C91B401  EXHIBITB  activity was completed. Follow-upi inspections for facility inspections that do notr resulti ina point accumulation requiring a re-inspection should not be performed absent a methodology approved by the State or under extenuating circumstances. a. The Contractor shall have a system for tracking all re-inspections that are required to maintain timely completion of all required re-inspections. 3, The Contractor shall record licensing, inspection, intervention, violation, violation pervasiveness, and compliance data using the State's digital database ort the Contractor's digital database as approvedi in writing by the State. 4. The Contractor shall complete progress reports when requested by the State. 5. The Contractor shall complete an electronic data transfer report each month or upon request by the State, ifnot using the State's digital database.  Primary Activity #2 The Contractor shall uniformly implement and administer the Food Protection. Act.  1. The Contractor shall issue new: and renewal! licenses and certificates ofl license using the State's digital database or approved Contractor-specific data system(s), and remit $43.00of the applicable licensing feei tol DEHS on a monthly basis. Format, wording and content included in Contractor invoices for license fees shall be provided by the State's digital 2. The Contractor shall respond to any plans ands specifications or HACCP plans submitted by a. The Contractor shall review and approve HACCP plans submitted by retail food establishments to verify that food] handling risks are reduced to prevent food-borne b. The Contractor shall review all submitted plans for new or extensively remodeled Ifal HACCP plan or other plan or specification is deemed inadequate, the Contractor shall providea a written response to the submitter with a statement describing how 3. The Contractor shall hear and determine all complaints against licensees or grantees of certificates of license and administer oaths and issue: subpoenas to require the presence of 4. The Contractor shall review all variance requests submitted by retail food establishments and provide a recommendation for approval or denial tol be considered by CDPHE. 5. The Contractor may enroll andi maintain progress inl FDA's VNRFPS as staffing resources 6. The Contractor shall participate in individual and statewide trainings offered by DEHS for the retail food program or supporting data system(s). 7. The Contractor shall participate ini the State's data standardization efforts. The Contractor shall conduct regulatory inspections and assure: regulatory compliance for child care facilities in accordance with state laws, regulations and standards. 1. The Contractor shalli inspect each licensed child care facility once every two years, or utilize the CDPHE Child Care risk-basedi inspection frequency methodology, or on a risk- based inspection frequency approved by the State and enter those inspection results into the Contractor's digital database or the State's digital database no later than two (2) working a. The Contractor shall inspect guest child care and public services short-term child care,  database or must be approved by DEHS. retail food establishments within 14 days. illness outbreaks. retail food establishments. such deficiencies may be corrected.  Sub-Activities #2  any person necessary to the determination ofanys suchl hearing.  allow.  Primary Activity #3  Sub-Activities #3  days after the activity was completed. ifoperating in their jurisdiction, annually.  Page2of7  Original Contract Number: 2024*0447  Ver.01,11.19    DocuSign Envelope ID: FEDC9BF0-46AF-4560-A124-5FDD4C91B401  EXHIBITB  b. The Contractor shall have a system for determining and tracking the next inspection dates duei in such a manner that allows for the Contractor to easily determine any past duei inspections.. As such, the Contractor shallr not havei inspections that are more than Ifextenuating circumstances cause the Contractor to be more than 90 days past due, the Contractor shall notify the Statei in writing oft the extenuating circumstances. 2. The Contractor shall record inspection, intervention, violation and compliance data into the Contractor's digital database ort the State's digital database nol latert than two (2) working 3. Ifrequired byt the agency, the Contractor shall review all plans submitted by child care facilities and provide written response within two weeks ofs submittal. 4. The Contractor shall review all variance requests submitted by child care facilities and provide a recommendation. for approval or denial to be considered by CDPHE. 5. The Contractor shall participate ini individual and statewide trainings offered by DEHS for the supporting data system andt the child care program, per Child Care Inspection Training Standards. These standards arei incorporated and made part oft this contract by reference. The Contractor shall conduct regulatory inspections and assure regulatory compliance for 1. The Contractor. shalli inspect thel high risk portions ofe each school that contains laboratory, industrial, art and/or vocational hazards (high risk only inspection) once per year and enter thosei inspection results into the Contractor's digital database or the State's digital database no later than two (2) working days after the activity was completed. High risk only inspections shall be conducted in accordance with the DEHS. School. Inspection. Procedures SOP.This document isi incorporated and made part oft this contract by reference. a. The Contractor. shall have a system for determining and tracking the next inspection dates duei in such a manner that allows for the Contractor to easily determine any past duei inspections. As such, the Contractor shall not! havei inspections that are more than b. Ifextenuating circumstances cause the Contractor to bei more than 90 days past due, the Contractor shall notify the State in writing of the extenuating circumstances. 2. The contractor shalli inspect the low risk portions ofe each school that does not contain laboratory, industrial, art and/or vocational hazards (lowr risk only inspection) at least once every three years ande enter those inspection results into the Contractor's digital database or the State's digital database no later thant two (2) working days after the activity was completed. Lowi risk only inspections shall be conducted in accordance with the. DEHS School Inspection Procedures SOP. This document isi incorporated and made part oft this a. The Contractor shall have a system for determining and tracking the next inspection dates due ins such a manner that allows for the Contractor to easily determine any past duei inspections. As such, the Contractor shall not have inspections that are more than b. Ifextenuating circumstances cause the Contractor toi be more than 90 days past due, the Contractor shall notify the State in writing oft the extenuating circumstances. 3. The Contractor shall record inspection, intervention, violation and compliance data into the Contractor's digital database or the State's digital database no later than two (2) working 4. Ifrequired by the agency, the Contractor shall review all plans submitted by schools and  90 days past due.  days after the activity was completed.  Primary Activity #4  schools in accordance withs state laws, regulations and standards.  90 days past due.  Sub-Activities: #4  contract by reference.  90 days past due.  days after the activity was completed.  provide written response within two weeks ofs submittal.  Page 3of7  Original Contracti Number: 2024*0447  Ver. 01.11.19    DocuSign Envelope ID: FEDC9BF0-46AF-4560-A124-5FDD4C91B401  EXHIBITB  5. The Contractor shall review all variance requests submitted by schools andj providea recommendation for approval or denial to be considered by CDPHE. 6. The Contractor shall participate ini individual and statewide trainings offered by) DEHS for the school program ors supporting data system(s). Retail Food Standards and Requirements 1. The Contractor shall comply with the Food Protection. Act, C.R.S. 25-4-1601, et.seq. This document isi incorporated and made part of this contract by reference. a. The Contractor shall comply with all other policies, regulations, interpretive memoranda, and guidance documents issued by DEHS which are used to clarify interpretation andi implementation of the governing laws. 2. The Contractor shall have at least one (1) employee that has successfully completed retail food establishment standardization through the DEHS, orl have one (1) employee who meets the: standardization eligibility requirements (including compliance with FDA's VNRFPS Standard 2) for standardization and participates in and successfully completes the standardization exercise whens scheduled by) DEHS. 3. VNRFPS information is available on thef following web site: htp-/AommvflgovPoodsssulatwiwcalfathaisimtionPogrmsamndhanlvle fault.htm andi isi incorporated and made part oft this contract by reference. 4. Progress int the FDA's VNRFPS will include: a. Participation in statewide committees for the development oft the State requirements b. Demonstration of advancement toward compliance with VNRFPS Standard2 assuring retail food inspectors meet national criteria for appropriate training, education and standardization to adequately perform required inspections and Demonstration ofa advancement toward compliance with VNRFPS Standard3 assuring a risk-based inspection focus, the correction of documented deficiencies, applying pervasiveness and statutory enforcement process, and assuring the focus of d. Coordination witht the department to facilitate DEHS audits of compliance audits Coordination with the department to conduct audits of DEHS for compliance with 5. The Contractor shall complete retail foodi inspections at a sufficient rate to protect public health and maintain a consistent presence int the community (i.e. approximately 25%of a. Ifextenuating circumstances cause the Contractor to complete less than 25% oft the annually-required: number ofinspections ina a quarter, the Contractor shall notify the b. When the Contractor lacks program budget to provide a staffing level of one full- time equivalent (FTE) devoted to retail food safety for every 320i inspections tol be performed, the Contractor shalli include suchi information int their written: notification tot the State. The Contractor shall use Standard 8 from the 2022 VNRFPS as the basis for calculations in support of this justification. (FTE requirements calculated in accordance with Standard 8r may be compared with funding provided through retail food license revenues andl local staffing costs whenj justifying proportionally The Contractor shall verify all licensing fees collected are directed towards retail  fora a particular standard. interventions.  Standards and Requirements  inspections on the highest risk establishments. performed as part OfVNRFPS. VNRFPS.  annually required inspections completed per quarter).  Statei in writing explaining the extenuating circumstances.  appropriate work completion) food program activities.  Page4 4of7  Original Contract Number: 2024*0447  Ver.01.11.19    DocuSign Envelope ID: FEDC9BF0-46AF-4560-A124-5FDD4C91B401  EXHIBITB  6. The Contractor shall use the State inspection forms (or digital equivalent), or ai form approved by the State, and mark the compliance status options for all violations as in compliance (In), out of compliance (Out), not applicable (NA), or not observed (NO) duringe each retail food establishment inspection. For each retail food violation marked out ofc compliance (Ou0,apervasivenes: determination ofl low, medium, or high shall be The Contractor shall, att the completion of each inspection, finalize the inspection report with thei inspection findings and review the results with the facility priort to leaving the establishment. Conditions and violations noted on the inspection report at the time oft the inspection cannot be altered after leaving the establishment without providing full documentation and explanation oft the alterations tot the facility. The necessity for any such alterations should be minimized to greatest extent possible and full documentation must also be recorded in State's digital database or the 7. Ifthe Contractor chooses to communicate retail food inspection results tot thej public, the 8. The Contractor shall maintain inspection and compliance records for retail food establishments in the State's digital database, ori ini the Contractor's State-approved digital a. Ana accurate and complete inventory of existing retail food establishments; b. Ther number of inspections and re-inspections conducted; Ther number ofi inspections that resulted in closure oft the inspected facility; d. Completion rates for required inspections and interventions; Ifany inspection reports were altered after issuance att the time ofi inspection, and the Whether the required inspection frequency was met; and The number of enforcement actions takent to obtain compliancei inj retail food  assigned.  Contractor's approved digital database. Contractor shall use the State-approved methodology. database in order for DEHS to determine:  number ofany such altered reports;  establishments.  Child Care and Schools Standards and Requirements  1. The Contractor shall provide inspections and assure compliance to establish ande enforce sanitary standards for the operation and maintenance of child care facilities ands schools and child care facilities in accordance with Section 5 of6CCR 1014-7, Core Public. Health a. When sufficient appropriations are absent, the Contractor shall set priorities for completing the required child care and school inspections, and include the list of priorities ini its local public health plan submitted pursuant to section 25-1-505,C.R.S. 2. The Contractor shall comply with the Colorado State) Board of Health Rules 60 CCR 1010- 2,6CCR 1010-6, 6CCR 1010-7, andt the Core Public. Health, Services regulations. These documents arei incorporated and made part oft this contract by reference a. The Contractor shall comply with all other policies, regulations, interpretive memoranda, and guidance documents issued byl DEHS which are used to clarify interpretation andi implementation of ther rules and regulations. 3. The contractor shall ensure compliance with the Child Care Inspection Training. Standards fore employees when conducting inspections in child care facilities. 4. Thec contractor shall ensure compliance with the School Inspection Training Standards for employees conducting inspections ins schools. 5. The Contractor shall use the Statei inspection forms (or digital equivalent), or ai form approved by the State, and mark the compliance status options for all violations as in compliance (In), out ofcompliance (Out), not applicable (NA), or not observed (NO) during each child care or school inspection.  Services.  Page 5of7  Original Contract Number: 2024*0447  Ver.01,11,19    DocuSign Envelope ID: EDC9BF0-46AF-4560-A124-5FDD4C91B401  EXHIBITB  a. The Contractor shall, at the completion of each inspection, finalize the inspection report with thei inspection findings and review the results with the facility prior to leaving the establishment, Conditions and violations noted on the inspection report at the time oft thei inspection cannot be altered after leaving the establishment without providing full documentation ande explanation oft the alterations to the facility. The necessity for any such alterations should be minimized to greatest extent possible and full documentation must also be recordedi in State's digital database or the 6. The Contractor shall maintain adequate inspection and compliance records for child care establishments and schools in a digital database in order for DEHS to determine: a. An accurate and complete inventory ofexisting child care facilities ands schools; b. Ther number ofi inspections due, past due, and completed; Ther number of non-critical and critical item violations cited during child care facility and: school inspections, and whether critical items identified on inspections were d. Completion rates for required inspections; and, Whether thet required inspection frequency was met.  Contractor's approved digital database.  corrected;  General Standards and Requirements  1. DEHS will provide the following report templates tot the Contractor: a. Progress report template or other reporting method. 2. Quarterly reporting may be provided using the Contractor's data system reporting capabilities (i.e. the Contractor can submit' "canned" reports with some or all data 3. The contractor shall actively participate in the planning for, execution of, and responses to comprehensive DEHS program audits of environmental health services provided to achieve the uniform statewide administration, implementation and enforcement of standards and rules established by the CDPHE for retail food establishments, child care facilities and 1. Complete inspections anda assure: regulatory compliance ini retail food establishments in proportion with the revenue generated from retail food license fees established1 by the State sot that the Contractor can maintain compliance with' Title 25, Article 4, Part 16, C.R.S. 2. Complete inspections and assure regulatory compliance in child care facilities and schools 1. Ther number ofretail: food inspections required to be completed by the Contractor during the State fiscal year (based on the State's risk-based inspection scheduling methods or an alternate risk-based: methodology approved by the State), and the number ofi inspections 2. The number of retail food re-inspections and facility closures required and completed in 3. Violation rates, by violation (checklist item), for retail food establishment inspections and associated rates of low, medium or high pervasiveness for each violation. 4. Ther number of child care facility inspections required tol be completed by the Contractor during the State fiscal year andi the number of child care facility inspections completed. 5. Ther number of high-risk school inspections required to be completed by the Contractor during the State: fiscal year and the number ofhigh-risk school inspections actually  elements).  schools.  Expected Results of Activity(s)  inj proportion with the funding provided through this contract.  actually completed. accordance with state law.  Measurement of Expected Results  completed.  Page 6of7  Original Contract Number: 2024*0447  Ver.01.11.19    DocuSign Envelope ID: FEDC9BF0-46AF-4560-A124-5FDD4C91B401  EXHIBITB  6. Ther number of1 low-risk schooli inspections required tol be completed by the Contractor during the State fiscal year andt the number oflow-risk school inspections actually  completed.  Completion Date No later than 15th day ofi following month  1. The Contractor shall remit $43.00 oft the applicable retail food licensing feet tol DEHS on ai monthly basis.  Deliverables  2. The Contractor shall submit an electronic data transfer each month No later than 15th in accordance with data standardization workgroup protocol (ifnot day of following using the State's digital database) to the Deputy Director OfDEHS, month 3. Upon request, the Contractor shall submit ani inspection and compliance progress summary (ifr not using the State's digital database) to the Deputy Director ofl DEHS, ort their designee, via request  ort their designee, via email.  Within 10 days of  email.  IV. Monitoring:  CDPHE'sI monitoring oft this contract for compliance with performance requirements will be conducted throughout the contract period by the Deputy Director ofDEHS. Methods used willi include ai review of documentation determined by CDPHE to be reflective of performance toi include progress reports, inspection inventories, inspection reports, site visits, electronic data andj joint inspections and other fiscal andj programmatic documentation as applicable. The Contractor's performance willl be evaluated: at set intervals and communicated to the Contractor. Al Final Contractor. Performance Evaluation will be  conducted att the end oft the life oft the contract. V. Resolution of Non-Compliance:  The Contractor will be notified in writing within fifteen (15) calendar days of discovery ofa compliance issue. Within thirty (30) calendar days of discovery, the Contractor and the State will collaborate, when appropriate, to determine the action(s) necessary to rectify the compliance issue and determine when the action(s) must be completed. The action(s) and time line for completion will be documented in writing and agreed to by both parties. Ifextenuating circumstances arise that requires an extension to the time line, the Contractor must email a request to the Deputy Director ofl DEHS and receive approval for a new due date. The State will oversee the compesionmplememation oft the action(s) to ensure time lines are met and the issue(s) is resolved. Ift the Contractor demonstrates inaction or disregard for the agreed upon compliance resolution plan, the State may exercise its rights under the provisions oft this contract.  Page 7of7  Original Contract Number: 2024*0447  Ver. 01.11.19    DocuSign Envelope ID: EDC9BF0-46AF-4560-A124-5FDD4C91B401  EXHIBITC  Budget  Agency Name Prowers County  Total $30,000.00  Quarterly Distribution $7,500.00  Original Contract Number: 2024*0447    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested: 6/13/2023 Submitter: Department of Human Services  Submitted to the County Administration Office on: 6/2/2023 Return Originals to: Department of Human Services Number of originals to return to Submitter: 1  Contract Due Date: ASAP  Item Title/Recommended Board Action:  Consider approval ofContract Amendment 1 to the Substance Use Disorder Services Agreement between the Arkansas Valley County Departments of Social Services and Signal, and authorizing Lanie Meyers-Mireles, Department ofHuman Services Director, to execute the document.  Justification or Background:  Fiscal Impact: This item is budgeted in the following account code:  County: $  Federal: $  State: $  Other: $  Approved by the County Attorney on: Additional Approvals (if required):    SIGNAL BEHAVIORAL HEALTH NETWORK  AMENDMENTI  This Amendment (the Amendment) is made to the Substance Use Disorder Services Agreement (the Agreement) previously executed by and between the Arkansas Valley County Departments of Social Services, hereinafter referred to as "SERDSS" (including Baca County, Bent County, Crowley County, Kiowa County, Otero County, and Prowers County) and Signal, hereinafter Itis mutually understood and agreed by and between the undersigned contracting parties to amend the previously executed agreement from June 1,2022 as follows: The County Core Services, period of performance shall be for the twelve-month period beginning, June 1, 2023 through May 31, 2024, unless sooner terminated. The Signal Additional Family Service (AFS) period of performance under this Agreement shall be for the twelve-month period beginning July 1, 2023 through June 30, 2024, All other terms and conditions that are: not IN WITNESS WHEREOF, this Amendment is entered into as oft the Effective Date first noted  referred to as "Signal". (the Agency).  hereby amended are to remain in full force and effect. above, notwithstanding actual date of execution.  Approved by:  Daniel Darting, Chief] Executive Officer  SIGNAL  Date  Jonna Parker, Director  BENT COUNTY DEPARTMENT OF SOCIAL SERVICES  Date  Donna Rohde, Director  OTERO COUNTY DEPARTMENT OF SOCIAL SERVICES  Date  Lanie Meyers-Mireles, Director  PROWERS COUNTY DEPARTMENT OF HUMAN SERVICES  Date  Dennis Pearson, Director  KIOWA COUNTY DEPARTMENT OF SOCIAL SERVICES  Date  Suml VFY333    Tonia Burnett, Director Agent  CROWLEY COUNTY DEPARTMENT OF SOCIAL SERVICES! Fiscal  Date  Shannon Mason, Director  BACA COUNTY DEPARTMENT OF SOCIAL SERVICES  Date  Signal VIY232    SIGNAL: BEHAVIORAL HEALTH NETWORK and  ARKANSAS VALLEY COUNTY DEPARTMENTS OF SOCIALSERVICES SUBSTANCE ABUSE TREATMENT SERVICE ACREIMENT-IRIANZ This Agreement is between the Arkansas Valley County Departments of Social Services, hereinafter referred to as "SERDSS" (including Baca County, Bent County, Crowley County, Kiowa County, Otero County, and Prowers County) and Signal Behavioral Health Network, hereinafter referred WHEREAS, Arkansas Valley County Departments of Social Services requires the services ofa substance abuse treatment provider to assist the Counties in delivering substance abuse treatment services WHEREAS, Signal is a Colorado non-profit corporation organized for the purpose of managing and coordinating high quality, cost efficient, integrated chemical dependency andi related behavioral health  CHILD WELFARE CLIENTS  toas" "Signal".  to child welfare clients, and Signal is willing and able to provide such services; and  care services int the State ofColorado.  NOW, THEREFORE, iti is mutually agreed as follows:  I.  SERVICES:  A. Responsibilities: of Signal  1. Signal agrees and desires to participate as the service coordinator for (SERDDS) qualified child welfare clients undert the definition set forthi in the Child Welfare Lawsuit Settlement 2. Signal will maintain a high quality of clinical care to clients ina a delivery system oflimited resources and public funding. Signal shall ensure that the full continuum of care (Outpatient, Intensive Outpatient, Transitional Residential, Intensive Residential, Therapeutic Community, Detoxification or comparable alternatives as mutually agreed upon) shall be available to clients through an agreed upon third party provider. As the service coordinator, Signal shall sccure via contract (which shall be provided to SERDSS) a third-party direct service provider ("Provider") for services set forth herein, SERDSS shall be named as a third party beneficiary to said contract. Services provided shall be on a fee-for-service basis as set forth herein. Said fees shall be paid (in order of priority) by private insurance, Medicaid or any other available program funding source before being paid by AFS or Core funding. Signal shall ensure that the services provided by Provider shall include, but not be limited to, thei following: a. Intake/Clinical Assessments (written) with treatment recommendations  Agreement (David Littman VS. State ofColorado).  3.  b. Consultations Individual Therapy d. On-going Outpatient Therapy Group Therapy  Case Management for clients entering inpatient treatment and: follow-up Assist ini the coordination ofi identified mental health services, as needed.  1of12    h. Signal will ensure that all referred child welfare clients on aj priority basis and complies  with thet following criteria:  The case is active on Trails Department ofl Human Services. shall result int the denial ofp payment.  ii. The case meets the State DHS program category criteria 4,5,or6 iii. The case meets the definition of "imminent risk for out-of-home placementreum.fication" set forth by the State of Colorado iv. That Provider properly bills private insurance, Medicaid, or any other available program funding before billing AFS or Core funding as set forth inj paragraph 3 above and any failure to follow said provisions  . Upon accepting a referral, that Provider complies with the following regarding the  receipt and processing of child welfare client referrals:  Provider schedules an initial intake within 51 business days of referral and notifies appropriate SERDSS member of the date and time of said appointment. Said intake shall be completed no less than 10 days from the ii, Provider shall submita at treatment plan tot the appropriate SERDSS member for each client seen within 30 days ofintake appointment. iti. Provider shall notify the appropriate SERDSS member within 41 business days ofa any urinalysis test performed. iv. Provider shall enter monthly progress reports into the Signal data system no later than the gth day ofe each month for services rendered  date of thei referral  4. Signal will assure that all eligible child welfare clients referred by SERDSS are in need of treatment outside of the above services listed in 3 above will receive such in accordance with ASAM PPC-IIR level of care, as reimbursed by the State of Colorado, Office of 5. Int the absence of any formal agreement beyond the term of this agreement, Signal agrees to continue providing treatment, under the terms of this agreement including reimbursement: rates, for clients that are in treatment or referred by SERDSS for treatment. Thisi is with the further understanding that service delivery and payment are subject to the termination terms mentioned above. Signal reserves the right to suspend services to clients iff funding is no longer available. SERDSS acknowledges financial responsibility for all services authorized and performed before the effective date oft termination. 6. Signal will provide a monthly billing statement to the SERDSS listing all expenditures by County, as well as the fund balance available for additional services.  Behavioral Health.  7.  Signal shall reconcile allt treatment providers' claims to. AFS: funds within current plus 90 days from the date ofs service delivery. Claims not properly submitted to Signal within this  time line willl be denied. B. Responsibilities of SERDSS  1.  SERDSS will work cooperatively with Signal and Provider to deliver quality, efficient and cost-effective substance abuse treatment services to SERDSS qualified clients.  2of12    2. SERDSS will make every effort to inform Signal and Provider of system issues, developments, and internal complications that may affect Provider's ability to provide 3. SERDSS will create all referrals for services and will ensure that they meet the eligibility criteria. Itis each ofthe Counties responsibilityt to approve/authorize all out ofnetwork/out  services ofaffect Signal andi its role as service coordinator. ofarea referrals. Specifically, SERDSS shall ensure: i. The case is active on Trails  ii. The case meets the State DHS program category criteria 4,5,or6 iii. The case meets the definition of"imminent risk for out-of-home placemenureunification: set forth byt the State ofColorado Department of  Human Services  4. 5,  SERDSS will verify payment modality (Medicaid, private insurance, other program funding or Core Services) in the referral. SERDSS reserves thei right to request a changei in the payment modality regarding any referred client based on a change in circumstances. SERDSS agrees to provide Signal with the name and contact information of a primary contact person at each county department who will be responsible for interacting with Signal's data system, and acti in the capacity as SERDSS administrator for other users of SERDSS will send a TRAILSI Remittance Advice and a Signal Remittance Summary (Exhibit A), or a mutually-agreedi upon alternate format, to Signal within 51 business days oft the monthly TRAILS Corel Main Payroll date if any portion ofp payment is denied. Such remittance advice shall detail the reasons for such denial.  the system.  6.  II. PERIOD OF PERFORMANCE  Due to different State funding cycles for Core and AFS, the period of performance under this Agreement will overlap. For the County Core Services, the period of performance shall be for the six-month period beginning, June 1, 021thromghNovember 30, 2021, unless sooner terminated. The Signal Additional Family Service (AFS). period of performance under this Agreement shall be for the five-month period beginning July 1, 2021 through December 31, 2021, unless sooner terminated. Either party hereto may terminate this. Agreement: at any timel by giving not lesst than 45 days advance written notice Asac condition of continuing to render services under this Agreement, iti is understood that Signal will report any limitation or restriction oft their license ori insurance or the ability to perform thes services covered by this Agreement under any condition of impairment.  tot the other party.  III. COMPENSATION  A. SERDSS agrees to contract with Signal for an annual (6/1/21-5/31/22) maximum of $58,000 from the SERDSS Core Services Substance. Abuse funds that are not Medicaid eligible services. These Core Services funds shalll be available for fee-for-services. B. Signal agrees to contribute an annual maximum 71/21-6/30/22) of$47,820 from SSPA4 Additional Family Services (AFS) OBH Funding towards substance abuse treatment serviçes in accordance with the terms herein. The. AFS funding shall be available for fee- C. Included ini the fee-for-service rate table below is a 5% administrative fee for Signal to  for-services.  3of12    manage these services.  Any compensation or reimbursement: for services provided, paid by Medicaid, private insurance, or other program funding source shall be the maximum amount recovered by Signal or Provider and SERDSS shall not be responsible for any difference in amount set Signal, the Counties and the! Providers acknowledge and accept that abstinence monitoring services MUSTE be provided in conjunction witht treatment services in order to Monitoring of client abstinence from alcohol and other drugs, using technologies such as urine analysis, breathalyzers, and the patch, are often useful adjuncts to treatment. Such monitoring may help clinicians and caseworkers to determine whether the client's treatment plan needs tol be revised or thei intensity oftreatmenti increased or decreased. The decision ast to whether abstinence monitoring is a useful part oft the client's treatment plan as well as related decisions on the type and frequency of monitoring are best madej jointly between the child welfare caseworker and the treating The County, Signal and the provider acknowledge that all UA: services MUSTb be physically monitoredobserved by an individual in order for payment to be considered. Signal, in accordance with Federal HIPAA regulations, adopted a standard transaction codes set for all treatment services on October 16, 2003," which are subject to change throughout each contract year. Even though this compliance changed the service labels and groupings (shown above), the net amount of the fees associated with those services  forth in the fee-for-services below. D. Fee-for Service Rates FY2021/2022:  bei reimbursed through Core and/or. AFS funds.  clinician.  has not changed.  Unit of Measure Each Each Each Each Each Each Each Each 15! Minute Session(s)  Service Code 80100:HF 80101 80102 81020 82055:OF 82055:SC 82075 83000:ES 84999 90791  Service Code Description UA- Ethyl Glucuronide (EtG) UA- 5 Panel UA Confirmation UA- quick cup or redi-cup Oral Fluid Panel Breathalyzer Hair Testing  Payor Rate $ 42.00 $ 14.70 $ 35.70 $ 17.85 $ 87.15 $ 63.00 $ 17.85 $ 84.00 $ 84.00 $ 68.25  UA- Synthetic Cannabinoids (Spice)  Expanded Designer Stimulants 14 panel Each  Psychiatric Diagnostic Evaluation  4of12    Psychiatric Diagnostic Interview Exam 15 Minute DEPRECATED: Medical testimony (travel, 15 Minute  $ 26.25 $ 42.00 $ 462.00 $ 15.75 $ 47.25 $ 28.88 $ 15.75 $ 15.75 $ 15.75 $ 21.00 $ 23.63 $ 23.63 $ 29.40 $ $ $ $ 157.50 $ 252.00 $ 325.50 $ 131.25 $ 157.50 $ 15.39 $ 36.75 $ 73.50  90801:F 99075 B0020 H0002 H0002:MH H0003:HF H0004 H0004:HE:GT H0004:HE:HFGT H0004:HH H0005 H0005:HE:GT H0005:HH H0006 H0006:HE:GT H0006:HE:HF:GT H0011 H0018:HB H2036:HF:05 H2036:HF:U7 H0018:HC H0019 H2036:HF:01  follow-up wait, prept time) Beacon Opioid Replacement (Methadone), per month Evaluation (LPC/LCSW) UAV w/TX Individual Counseling  Session(s) Session(s) Month(s) 15 Minute Session(s) Session(s) Each 15 Minute Session(s) 15 Minute 15 Minute Session(s) 15 Minute Session(s) Hour(s) Hour(s) Hour(s) 15 Minute Session(s) 15 Minute Session(s) 15 Minute Day(s) Day(s) Day(s) Day(s) Each Hour(s) Hour(s)  Evaluation: Mental Health Assessment 15 Minute  Individual Counseling w/HE:GT modifier Session(s) Individual Counseling w/HE:HF:GT Individual counseingto.Occurng Group Counseling Group Counseling Group CounselingcoOrcuring Case Management  modifier  Case Management w/HE:GT modifier Case Management W/HE:HF:GT modifier Session(s) Intensive Short-Term Residential:,Adult Day(s) Intensive Short-Term Residential,Adult Co-occurring Transitional Long-Term Residential Transitional Long-Term Opioid Replacement (Methadone), per encounter Family Counseling Family CounselngcoOrcuring  Detox  H0019:HD H2036:HF:01 ResidentialPreg/Parent (NDF)  H0020 T1006 T1006:HH  5of12    E. AFSONLY-SERDSSFY2021  The following services are available exclusively through AFS funds and must be purchased in conjunction with the residential treatment services described in thei fee-for-  service schedule above:  AFS (200) Room and Board AFS (200) Room and Board AFS (200) Room and Board  59976:H Residential Room and Board: Adolescent, per Day(s $73.5  A S9976:H B D  diem  0 Day(s $73.5 0 0  Residential Room and Board: Adult, per diem  $9976:H Residential Room and Board: Preg/Parent, per Day(s $73.5  diem  IV. CLIENT! FEES OR CO-PAYS  Neither Signal nor Provider shall assess a client fee or co-pay to child welfare clients served under this contract, unless the client is required toj pay for any positive urine screen as a  condition of their Family Service Plan.  V. ATTACHMENTS  Signal and SERDSS agree to adopt! herein Exhibit A- Signal) Remittance Advice; Exhibit B-C Qualified Service Organization Agreement; Exhibit C-1 Definitions  VI. INDEPENDENT CONTRACTOR  Signal is an independent contractor of SERDSS. Nothing herein shall be interpreted as creating ane employer-employee: relationship,joint" venture, or partnership between SERDSS  and Signal or any contracted Provider. VII. NON-DISCRIMINATION  Itis the policy of Signal toj provide equal opportunity without discrimination based on race, color, sex, religion, age, sexual orientation, national origin, veteran status, or individual handicap in any aspect of employment, training or services offered. All Signal programs, activities, and services are administered on a non-discriminatory basis subject to the  provisions of:  Title VI and VII oft the Civil Rights Act of 1964  6of12    Executive Order 11246, as amended Title VII and VIII of the Public Health Services Act Rehabilitation Act of1973 (Section 503 and 504) Equal Pay Act of 1963, as amended Title IX ofthe Education Amendments of 1972 Vietnam Era Veteran's Readjustment Assistance. Act of1974 Age Discrimination in Employment. Act of 1967 Agel Discrimination Act of1975 Non-Discrimination Laws oft the State ofColorado. VIII. ACCESS TO1 RECORDS  Signal and SERDSS agree to make available in a timely manner all books, documents, and records pertinent to this contract for the purpose of billing for services, audit, and compliance with requirements and regulations of federal and state agencies and Signal further agrees to provide monthly utilization reports for each of the SERDSS directors including expenditures by county for Core and AFS services. Signal and SERDSS acknowledge that in reviewing, storing, processing, or otherwise dealing with any client records dealing with any client seen by a Signal provider or the on- site substance abuse counselors that iti is bound byt the confidentiality provisions of42CFR Part2. Ifnecessary, Signal and SERDSS shall resisti inj judicial proceedings any efforts to obtain access to client records except as permitted by 42 CFR Part2 2. SERDSS and Signal shall sign a Qualified Service Organization Agreement in compliance with 42 CFR, Part  commercial insurance carriers.  2. IX. OBLIGATIONS  Obligations of SERDSS and Signal are contingent upon funds for that purpose being  appropriated, budgeted and otherwise made available.  X. PROVISIONS  This Agreement may be amended only by written agreement signed by each oft thej parties hereto. This Agreement shall be binding upon, and shall inure to the benefit of the respective parties hereto ands shall not be assigned without the consent ofall parties hereto. Any notice required to be given pursuant to the terms and provisions hereof shall be in  XI. NOTICES:  writing and shall be sent by certified mail, return-receipt requested;  To Signal at: Daniel Darting, CEO Signal Behavioral Health Network 6130 Greenwood Plaza Blvd., Suite 150 Greenwood Village, CO80111 Tol Bent County at: Jonna Parker, Director 138 6th Street  7of12    Las Animas, CO 81054 To Otero County DSS at: Donna Rohde, Director POI Box 494 La. Junta, CO81050 Tol Prowers County DHSa at: Lanie Meyers-Mireles, Director POI Box 1157 Lamar, CO81052 Tol Kiowa County DSS at: Dennis Pearson, Director POI Box 187 Eads, CO81036 To Crowley County DSS at: Tonia Burnett, Director 631 Main Street, Suite 100 Ordway, CO 81063 Tol Baca County DSS at: Jonal Mills, Director 772 Colorado Street, Suite 1 Springfield, CO81073 XII. DISPUTE RESOLUTION  Itis the desire of all parties to resolve disputes at the Signal/County level through shared decision making. The County and Signal shall attempt to resolve all disputes at the lowest level possible within each organization. Ift the parties fail to: reach an agreement, the issue shall be documented and submitted to Signal's Chief Executive Officer and the County Department ofHuman Services Director (or their designee). Such documentation: shall include a statement oft thei issue(s), position ofboth parties, and each party's specific request(s). Ifs Signal andi the County are unable to resolve the dispute, either party may submit the dispute to the Colorado Department of Human Services, The State shall review all documentation regarding the dispute and provide written findings to the parties.. Ifeither party disagrees with the State's findings, the aggrieved party may pursue additional dispute resolution processes as allowed by law. Notwithstanding the above, nothing herein shall be construed to limit either party's right to resolve any dispute in court if mediation/arbitration is unsuccessful. Nothing herein shall be construed as a waiver of any defense or affirmative defense  Child Welfare and. Alcohol and Drug Abuse Division.  to any claim or rights to attorney's fees. XIII. MISCELLANEOUS PROVISIONS  A. Headings. The headings of the sections and subsections oft this Agreement are inserted solely fore ease ofreference ands shall noti ins any waya affect the meaning or interpretation ofthis Agreement. B. Non-Assignment. None of the parties shall have the right to assign the benefits or delegate the obligations in this Agreement without prior written consent of the other  8of12    parties. Subject to the foregoing, this Agreement shall be binding upon andi inure to the benefitofthe parties andt theirr respective! heirs, successors, legal or personal representatives C.V Waiver of] Breach. The waiver of any party ofal breach or violation of any provision of this Agreement shall not operate as, or be construed to be, a waiver of any subsequent D. Gender and) Number. Whenever the context of this Agreement: requires, the gender of all words shall include the masculine, feminine and neuter, and the number of all words E. Severability. If any provision of this Agreement is held to be unenforceable for any reason, thet unenforceabilityi thereofshall: not affect thei remainder ofthis Agreement, which shall remain in full force and effect and be enforceable in accordance withi its terms. F. Counterparts. This Agreement may be executed in duplicate originals, each of which shall be an original instrument but both of which taken together shall constitute one and G.Entire Agreement. This Agreement constitutes the entire understanding and agreement between the parties with respect to its subject matter and supersedes all prior agreements or understandings, whether written or unwritten, with respect to the same subject matter. H. Hold Harmless. To the extent authorized' by law each party shall indemnify, save and hold harmless the other and the Colorado Department of Human Services, against any and all claims, damages, liability and court awards including costs, expenses, and attorney fees incurred as al result of any act or omission by the party's employees, agents, subcontractors, ora assignees, or arising outo ofany dispute between the SERDSS, Signal, Network! Providers and the State Department of] Human Services in connection with the Agreement.  and permitted assigns.  breach of the same or any other provision thereof.  shall include singular and plural.  the same instrument,  9of12    EXHIBITB  SIGNAL BEHAVIORALHEALTH NETWORK QUALIFIED SERVICE ORGANIZATION AGREEMENT  Signal Bchavioral Health Network (MSO) and Baca, Bent, Crowley, Kiowa, Otero and Prowers County Departments of Social Services (Counties) hereby enter into a Qualified Service Organization. Agreement whereby the MSO agrees to accept and serve Counties' clients substance abuse treatment needs. The Counties agrec that Crowley County shall receive all bills from the MSO and act as the billing clearinghouse for all Counties. In light of the relationship between the Counties and the MSO, the Counties require client identifying information and data and information related to the services fumished to the clients. The Counties and MSO will have this relationship from. June 1,2021 -. June 30, 2022, thus  the QSOA willl bei in effect during this period of time.  Furthermore, the Counties:  1. acknowledge that in receiving, storing, processing, or otherwise dealing with any information from the MSO about the clients in the MSO's program, it is fully bound by the provisions of the federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records, 42 CFR Part 2; and 2. undertakes to resist in judiçial proceedings any effort to obtain access to information pertaining to clients otherwise than as expressly provided for in the federal confidentiality regulations, 42  CFR Part2. Executed this  day of  2021.  Daniel Darting, CEO Signal Behavioral Health Network Lanie Meyers-Mireles, Director Prowers County Dennis Pearson, Director Kiowa County Shannon Mason, Interim Director Baca County  Jonna Parker, Director Bent County DonBohde Donna Rohde, Director Otero County Tonia Burnett, Director Crowley County-Fiscal Agent  12of12    APPROVED BY:  Daniel Darting, Chiefl Executive Officer SIGNAL BEHAVIORAL HEALTHI NETWORK  Date  Jonna Parker, Director  BENT COUNTY: DEPARTMENT OF SOCIAL SERVICES  Date  Donna Rohde, Director  OTERO COUNTY DEPARTMENT OF SOCIAL SERVICES  Date Wa4lzel Date  Hunnuko Lanie Meyers-Mireles, Director  PROWERS COUNTY DEPARTMENT OFI HUMAN SERVICES  Dennis Pearson, Director  KIOWA COUNTY DEPARTMENT OF SOCIAL SERVICES dorhhuit  Date 5-0801 Date  Tonial Bumett, Difectoy Agent  CROWLEY COUNfY DEPARTMENT OF SOCIAL SERVICES/ Fiscal  Shannon Mason, Director  BACA COUNTY DEPARTMENT OF SOCIALSERVICES  Date  10of12    EXHIBITB  SIGNALI BEHAVIORAL HEALTH NETWORK QUALIFIED SERVICE ORGANIZATION. AGREEMENT  Signal Behavioral Health Network (MSO) and Baca, Bent, Crowley, Kiowa, Otero and Prowers County Departments of Social Services (Counties) hereby enter into a Qualified Service Organization Agreement whereby the MSO agrees to accept and serve Counties' clients substance abuse treatment needs. The Counties agreet that Crowley County shall receive allbills from thel MSO: and act: as theb billing clearinghouse for all Counties. In light oft the relationship between the Counties and the MSO, the Counties require client identifying information and data and information related to the services furnished to the clients. The Counties and MSO willl have this relationship from. June 1, 2021-3 June 30, 2022, thus the QSOA willl be in  effect during this period ofti time. Furthermore, the Counties:  1. acknowledge that in receiving, storing, processing, or otherwise dealing with any information from the MSO about the clients in the MSO's program, it is fully bound by the provisions of the federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records, 42 CFR Part 2; and 2. undertakes to resist inj judicial proceedings any effort to obtain access toi information pertaining too clients otherwise than as expressly provided for in the federal confidentiality regulations, 42 CFRPart2.  Executed this 25_day of May  2021.  8 Daniel Darting, CEO Signal Behavioral Health Network le Lanie Meyers-Vlireles, Director Prowers County Dennis Pearson, Director Kiowa County Shannon Mason, Interim Director Baca County  Jonna Parker, Director Bent County Donna Rohde, Director Oterp County Cbhebuet Tonia Burnett, Divéctor Crowley County-Fiscal Agent  12of12    APPROVEDI BY:  d 85 Daniel Darting, Chief Exeçutive Officer SIGNAL BEHAVIORAL HEALTH NETWORK  6/3/2021 Date  Jonna Parker, Director  BENT COUNTYDEPARTMENT OFSOCIALSERVICES  Date  MhnnBohcb Donnal Rohde, Director  5343031 Date  OTERO COUNTYDEPARIMENT OF SOCIALSERVICES  Lanie Meyers-Mireles, Director  PROWERS COUNTY DEPARTMENT OFI HUMANSERVICES  Date  Dennis Pearson, Director  KIOWA COUNTY DEPARTMENT OF SOCIAL SERVICES  Date  Tonia Burnett, Director Agent  CROWLEY COUNTY DEPARTMENT OF SOCIAL SERVICES! Fiscal  Date  Shannon Mason, Director  BACA COUNTY, DEPARTMENT OFS SOCIALSERVICES  Date  10of12    APPROVED BY:  Daniel Darting, Chief Executive Officer SIGNAL BEHAVIORAL HEALTH NETWORK  Date  Jonna Parker, Director  BENT COUNTY DEPARTMENT OF SOCIALSERVICES  Date  Donna Rohde, Director  OTERO COUNTYI DEPARTMENT OF SOCIAL: SERVICES  Date  Lanie Meyers-Mireles,' Director a  PROWERSCOUNTYI DEPARTMENT OFI HUMAN SERVICES  Date Shsfen Date  Dennis Pearson, Dipector  KIOWA COUNTYI DEPARTMENT OF SOCIAL: SERVICES  Tonial Burnett, Director Agent  CROWLEY COUNTY DEPARTMENT OF SOCIAL SERVICES Fiscal  Date  Shannon Mason, Director  BACA COUNTY DEPARTMENT OF SOCIALSERVICES  Date  10of12    EXHIBIT A  CORE Monthly Remittance Advice for Signal: Instructions: Please remit this report to Signal each month with your Trails Remittance. Payroll Report. Mail to: Signal Behavioral Health Network Attn: Tiffany Scroggins 6130 Greenwood Plaza Blvd. Suite 150 Greenwood Village, CO 80111  County Name: Date of Invoice: Fund' Type (i.e. AFS or Core) Original Amount ofInvoice:  **Ify you are submitting payments from prior month's bills with the current month's payment, please enter "$0.00" for the "Amount Billed" and then the amount paid in the' "Amount  Paid" column.  Denied/Additional. Services Report**: Client L.D. Dates of Service Amoun Amount  Reason Denied:  Sponsor Name Name # Service Type tBilled Paid  Totals:  Total Amount Denied Services:  (this amount should equal the amount of the county's EFT)  Total Amount of County Remittance:  Have Questions? Signal Tiffany Scroggins, Ph. 720-263-4860  Contacts: Email: bcroggin@sgmabhnorg  11of12    EXHIBITB  SIGNALBEHAVIORALHEALTH NETWORK QUALIFIED SERVICE ORGANIZATION AGREEMENT  Signal Behavioral Health Network (MSO) and Baca, Bent, Crowley, Kiowa, Otero and Prowers County Departments of Social Services (Counties) hereby enter into a Qualified Service Organization Agreement whereby the MSO agrees to accept and serve Counties' clients substance abuse treatment needs. The Counties agree that Crowley County shall receive all bills fromt thel MSO: and acta as thet billing clearinghouse for all Counties. Inl light oft the relationship between the Counties and the MSO, the Counties require client identifying information and data and information related to the services fumished to the clients. The Counties andl MSO will havet thist relationship from. June 1,2 2021- June 30, 2022, thus the QSOA willl bei in  effect during this period oft time. Furthermore, the Counties:  1. acknowledge that in receiving, storing, processing, or otherwise dealing with any information from the MSO about the clients in the MSO's program, iti is fully bound by the provisions oft the federal regulations govering Confidentiality of Alcohol and Drug Abuse Patient Records, 42 CFR Part 2; and 2. undertakes to resisti inj judicial proceedings any effort to obtain access toi information pertaining to clients otherwise than as expressly provided for in the federal confidentiality regulations, 42 CFRI Part2.  Executed this 2éraye of Mas 2021.  6/3/2021 Jonna Parker, Director Bent County Donna Rohde, Director Otero County Tonia Bumett, Director Crowley County-Fiscal Agent   35 Daniel Darting, CEO Signal Bchavioral Health Network R2  Lanie  Dennis Pearspm.Director Kiowa County Shannon Mason, Interim Director Baca County  12of12    PROWERS COUNTY AGENDA ITEM REQUEST FORM  Hearing Date Requested: 6/13/23 Submitter: Department ofH Human Services  Submitted to the County Administration Office on: 6/2/23 Return Originals to: Department of Human Services Number of originals to return to Submitter: 1  Contract Due Date: ASAP  Item Title/Recommended Board Action:  "Consider approval of Contract Amendment #5 of21 IHIA 168429 between Prowers County Department of Human Services and the Colorado Department ofl Early Childhood for the provision oft the Colorado Fatherhood F.I.R.E. grant and authorize the DHS Director, Lanie  Meyers-Mireles to exeçute the contract via DocuSign."  Justification or Background:  Fiscal Impact: This item is budgeted ini the following account code:  County: Federal: State: Other:  Approved by the County Attorney on: Additional Approvals (if required):  PLEASE ATTACHTHIS SHEET TO. ALL. AGENDA. ITEMS WHEN SUBMITTING TO  COUNTY ADMINISTRATION.  THANK YOU!    COLORADO Department ofE Early Childhood  CONTRACT AMENDMENT #5 SIGNATURE AND COVER PAGE  State Agency Colorado! Department ofl Barly Childhood 710 South Ash Street, Building C Glendale, CO 80246 Contractor Prowers County Department of Human Services P.O. Box 1157; 1001 S. Main St. Lamar, CO 81052 Current Contract. Maximum. Amount Initial Term 05172021-09292021 Extension Terms 09302021-09292022 0930202-09292023 09302023-09292024 Total for All State Fiscal Years  Original Contract Number 21 IHIA 168429 Amendment Contract Number 24QAAA 184344  Contract Performance Beginning Date May 17,2021 Current Contract Expiration Date September. 29, 2024  $108,693 $108,693 $109,923 $123,271 $450,580  Signature Page begins on next page *  Amendment Contraci Number: 240 QAAA 184344  Pagelof4  CDEC V.21 Rev. 07/08/2022    COLORADO Department ofE Farly Childhood CONTRACTOR  THE PARTIES HERETO HAVE EXECUTED THIS. AMENDMENT  Each! person signing this Amendment represents and warrants that! he or shei is duly authorized to execute this Amendment  and to bindt thel Party authorizing his or her signature.  STATE OF COLORADO Jared Polis, Goveror Coloradol Department of Early Childhood Lisal Roy, Ed.D., Executive. Director By: Lisa Castiglia, Deputy Chief Financial Officer  Prowers County Department of Human Services  By: Lanie Meyers- Mireles, Director  Date:  Date:  In accordance with $24-30-202 C.R.S., this Amendment ist not valid until signed and dated below byt the State Controller ora an  authorized delegate. STATECONTROLLER RobertJaros, CPA, MBA, JD  By:  Andrea Eurich/Toni Williamson/ /Telly Belton  Amendment Effective Date:  - Signature and Cover Pages End =  Amendment Contract Number: 240 QAAA 184344  Page2of4  CDEC V.21 Rev. 07/08/2022    COLORADO Department ofE Early Childhood  PARTIES State. 2. TERMINOLOGY  This Amendment (the "Amendment")t to the Original Contract shown on the Signature and Cover Page for this Amendment (the "Contract") is entered into by and between the Contractor, and the Except as specifically modified by this Amendment, all terms used in this Amendment that are defined in the Contract shalll be construed and interpreted in accordance with the Contract.  3. AMENDMENT EFFECTIVE DATE AND TERM A. Amendment Effective Date  This Amendment shall not be valid or enforceable until the Amendment Effective Date shown on the Signature and Cover Page for this Amendment. The State shall not be bound by any provision oft this Amendment before that Amendment Effective Date, and shall have no obligation to pay Contractor for any Work performed or expense incurred under this Amendment either! before or after ofthe. Amendment term showni in $3.B ofthis Amendment. The Parties' respective performances under this Amendment and the changes to the Contract contained herein shall commence on the Amendment Effective Date shown on the Signature and Cover Page for this Amendment or September 30, 2023 whichever is later and shall  B. Amendment Term  terminate on the termination of the Contract.  4. PURPOSE  Prowers County Department of] Human Services shall provide specialized outreach to fathers with children receiving Medicaid, single parent fathers, noncustodial fathers, military veteran fathers, fathers without a high school diploma, fathers participating in Head Start, fathers reentering after incarceration, fathers with a history of involvement in the foster care system, and unemployed fathers. Prowers County DHS shall build capacity and partnerships to more effectively serve fathers to improve the well-being of children by increasing thej proportion of children growing up with involved, responsible, and committed fathers. This amendment shall extend the contract expiration date, increase funds for FFY24 services and amends Exhibits A, B,D, and E. The Contract and all prior amendments thereto, if any, are: modified as follows:  5. MODIFICATIONS  A. Extend the Contract Expiration Date from September 29, 2023, to September 29, 2024. The Contract Initial Contract Expiration Date on the Contract's Signature and Cover Page is hereby deleted and replaced with the Current Contract Expiration Date shown on the B. Increase the Contract Amount for FFY24 by $123,271 and Increases the Maximum The Contract Maximum Amount table on1 the Contract's Signature and Cover Page is hereby deleted and replaced with the Current Contract Maximum Amount table shown on the  Signature and Cover Page for this Amendment.  Amount for All State Fiscal Years from $327,309 to $450,580.  Signature and Cover Page for this Amendment.  Amendment Contract Number: 24QAAA 184344  Page3of4  CDEC V.21 Rev. 07/08/2022    COLORADO Department ofE Early Childhood Exhibit A - Statement of Work added tol Exhibit. A ofthe Original Contract. added to Exhibit B oft the Original Contract. E. Exhibit D - Additional Provisions replace Exhibit D of the Original Contract. F. Exhibit E - Supplemental Provisions for Federal Awards added to Exhibit E oft the Original Contract. LIMITSO OF EFFECT AND ORDER OF PRECEDENCE  Exhibit. A - Amendment #5, which is attached andi incorporated by this Amendment, shall be Exhibit B - Amendment #5, whichi is attached andi incorporated by this Amendment, shall be Exhibit D - Amendment #5, which is attached and incorporated by this Amendment, shall Exhibit E- Amendment #5, which is attached and incorporated by this Amendment, shall be  D. Exhibit B - Budget  This Amendment is incorporated by reference into the Contract, and the Contract and all prior amendments or other modifications to the Contract, if any, remain in full force and effect except as specifically modified in this Amendment. Except for the Special Provisions contained in the Contract, in the event of any conflict, inconsistency, variance, or contradiction between the provisions of this Amendment and any oft the provisions of the Contract or any prior modification tot the Contract, the provisions of this Amendment shall in all respects supersede, govern, and control. The provisions of this Amendment shall only supersede, govern, and control over the Special Provisions contained in the Contract to the extent that this Amendment specifically  modifies those Special Provisions.  Amendment Contractl Number: 24 QAAA 184344  Page 4of4  CDEC V.21 Rev. 07/08/2022    8                                    ii     Exhibit B-Amendment: #5  COLORADO paptemayaNa Contractor Name Budget Period Project Name  Colorado Department ofE Early Childhood BUDGET WITH) JUSTIFICATION FORM  Program Contact Name," Title Phone Emall Fiscal Contact Name, Title Phone Email  Lanie Meyers-Mireles 719-336-7486x127 haetepowmcmant LisaF Farmer 719-688-3696 molopéromcamyae  Prowers County Department of Humans Services  9/30/23-9/29/24 Coloradol Fatherhood! Program Site  Expenditure Categories  Personne! Services Salaried Employees Description of Worka and Fringe Benefits Include: Fringei includes health, life, vision, unemployment ins, workers comp, CO-PERA contribution: and other expenses as deemed Cross or Annual appropriate other tasks as deemed appropriate bys supervisor. Fringe includes! health,! life, vision, unemployment Ins, workers comp, CO-PERA contribution: ando other expenses as Provide supervision: ando oversight of the Fatherhood supervisor. Fringel includes: health insurance, life insurance, vision, CO-PERA retirement contribution: and other expenses as deemed appropriate. healthi insurance, lifei insurance, vision, and CO-PERA retirement contribution.  9/30/23-9/29/24  Percent of Time on Fringe $13,220 100.00%  TotalA Amount $58,220  Position Title Visitor  Salary $45,000  Project Requested from CDEC  Fatherhood/ Advocate/Home Adminster alla aspects oft the Fatherhood program and  deemeda appropriate  Special Programs Supervisor  $74,988  $17,309 20.00%  $18,459  Supernvsor/Fatherhod program and other tasks as deemed appropriate by  Business Office Manager Business office anda accountings services. Fringei includes:  $66,924  $16,289 7.00%  $5,825 $82,504 9/30/23-9/29/24 TotalA Amount Requested from CDEC $2,400 $2,400  Total Personnel Services (including fringe benefits)  Contractorsy/Consutants (payments tot third parties ore entities)  Name  Description ofl Item  CFO  Accounting contractor. Wilp prepare and submitr monthlyi invoicest to CDEC.  Total Contraclor/Consulants,  Travel  9/30/23-9/29/24 TotalA Amount Requested from CDEC $2,730 $2,730  Item Mileage andt travel  Description ofl Item  Mileage, perc diem ford case management, meetings, conferences, trainings, lodging, airfare, etc.  Total Trave!  Page1 of2    Exhibit B-Amendment #5  Supplies & Operating Expenses  9/30/23-9/29/24 Total Amount Requested from CDEC $2,495 $9,000 $5,775 $1,000 $3,992 $1,500 $800 $4,900 $2,400 $31,862 $0 $0 $31,862 9/30/23-9/29/24 Total Amount Requested from CDEC  Item FHIS Subscription Meetings/Mentors Incentives Child Care Food Transportation Books Cell Phone  Description ofl Item  Financial Health Subscription Facilitator for and coordination of classes, mentors, meeting needs Incentives, social activities, programs supports Childo care Meals ands snacksf forr meetings anda activities Transportation, gas expenses, travel needs Books/journals Cell phone, cells service, wifi, hots spot No costs int this category shall ber reimbursed! by CDEC.  Materials and Supplies Marketing, Materials, and Supplies (workbooks, pens, paper, copies, etc.).  Subtotal  Items Excluded froml MTDC: (Rental costs, tuition, cholarmpy/elowanp), participant support, equipment, capital expenditures)  Subtotal Items removed from MTDC Total Supplies & Operating Expenses  Training: and1 Technical Assistance  Item Conferences Training  Description ofl Item  Conference Registration Childs Support Conference Registration and/or other pertinent conferences  $250 $3,000 $525 $3,775 $123,271 $123,271  Grantee Orientation, Biennial Conference, Strengthening Families Conference ando other pertinent conferences CFSA2.0T Training, NDAP, Circle of Parent, Protective Factors or Other Relevant Training  Total Training andl Technical Assistance MODIFIED TOTAL DIRECT COSTS (MTDC)  TOTAL DIRECT COSTS  Uniform Guidance! 52 200.68- -MTDCI means allo direct salaries andy wages, applicable fringe! benefits, materials ands supplies, services, travel, and upt to thef first $25,000 ofe eachs subaward. MTDCE excludes equipment, capitale expenditures, charges for patient care, rentald costs, tuitionl  remission, scholarships: andf fellowships, participant: support costs and the portion ofe each subawardi in excess of$ $25,000. exceed 10% unless Negotiated Federal Indirect Cost rate or Negotiated Statel Indirect Cost ratei is attached)  Indirect Costs  [notto  9/30/23-9/29/24 Total Amount Requested from CDEC  Item  Description ofl Item  No costs int thiso categorys shall ber reimbursed by CDEC.  so $0 $123,271  Total Indirect TOTAL  *Figures are rounded using basic accounting standards. (0.00-0,49-0;0 0.50-0.99=1.0)  Page 2of2    COLORADO Department ofE Early Childhood  Exhibit D -Amendment #5  ADDITIONAL PROVISIONS  1.S SERVICE PROVISIONS  The Contractor shall provide the services according to the plans submitted in the "Statement of Work", attached and incorporated herein by this reference as EXHIBIT. A. Inall cases, the descriptions, plans, timetables, tasks, duties, and responsibilities oft the Contractor as described in the Statement of Work, shall be adhered to in the performance oft the requirements oft this contract. In the event ofac conflict, the terms and conditions of this contract shall control over the Statement of Work. Any significant changes to the Statement of Work (SOW) The Contractor shall be responsible for the achievement of any goals and objectives as specified within the Statement of Work (EXHIBIT A) ofthis contract unless written notice of any modifications are furnished by the State to the Contractor allowing adequate time for compliance during the term oft this contract. The Contractor shall provide to the State a copy of any executed subcontract between the Contractor and any provider ofs services to fulfill any requirements ofthis contract. Subcontracts shall be emailed to the Contract  require an amendment to the contract. 2. GOALS AND OBJECTIVES  3. COPY OF SUBCONTRACT Representative upon execution.  4.1 PAYMENT  Inc consideration of the provision of services and reporting and subject to all payment andj price provisions and further subject to verification by the State of full and satisfactory compliance with the terms of this contract, the State shall pay to the Contractor an amount not to exceed the amount specified in the Budget (EXHIBIT B), of A. The Contractor shall submit requests for payment to CDEC Invyoicing@state.co.us no less than monthly  this contract.  on forms prescribed and provided by the State.  B. Payment shall be made on a cost reimbursement basis for services rendered.  C. Itis understood any vacancy savings in the personnel category and/or any savings in any other category shall require written approval from the State prior to any redistribution of any savings by the Contractor. ANY COST SAVINGS THAT ARE REDISTRIBUTED: BY CONTRACTOR WITHOUT WRITTEN D. ITIS UNDERSTOOD ANY COSTS THAT EXCEED THE CONTRACTED AMOUNT SHALL NOT BE PAID BY CDEC. IfContractor bas al legitimate need for additional funds, the Contractor shall request additional funds from the CDEC 60 days prior toj projected depletion of contracted funds. CDEC shall review each request and notify Contractor in writing of approval or denial. Approval of additional funds shall require an official modification to the Contract by Amendment or Option Letter. E. Timely Invoicing Invoices shall be submitted no later than 30 days following the last day oft the month. Final invoices for services provided September shall be submitted no later than 30 days following the last  APPROVAL SHALL: NOT BEI REIMBURSED BY THE STATE.  day oft the month.  Page1of4  Revision Date 03/01/2023    COLORADO Department ofE Early Childhood  ExhbitD-Amendmentss  The Contractor shall maintain source documentation to support all payment requested pursuant to this contract. All source documentation shall be provided tot the State by the Contractor upon request. Itis understood that the State reserves the right to offset funds pursuant to this contract based on the discovery of overpayment or improper use of funds by the Contractor. Overpayment or improper use of funds is interpreted to apply to specific terms of prior year contracts, andi includes without limitation requirements of the Generally Accepted. Accounting Principles (GAAP) issued by the American Institute ofCertified. Public Accountants, and applicable sections oft the Colorado! Revised Statutes. H. The State shall review monthly invoices throughout the fiscal year. If, after a number of months, the State determines the Contractor is not needing/using the funding allocated for the Contractor's work in the Contract, the State shall remove these funds from the contract budget by Option Letter for aj proportional reduction ofs services with prior written notification to the Contractor. This provision does not allow fora  reduction in the rate of pay.  5.1 PARTICIPATION meetings related to this contract. 6. SUPPLANTING  The Contractor representative(s) is required to participate in any Department ofEarly Childhood sponsored Payments made to the Contractor under this contract shall supplement and not supplant other state, local or  federal expenditures for services associated with this contract.  7.1 BUDGET CHANGES  Contractor may request in writing adjustments to the direct costs int the current year budget (EXHIBIT B) not to exceed 10% of the total budget. Requests shall be made in the form ofa written budget revision request to the appropriate program staff. Written approval for the budget revision shall bei required prior to any changes to the budget related to thel budget revision request. The total dollar amount oft the contract budget cannot be changed as ai result oft the budget revision request. Budget adjustment requests over 10%, adding new expense lines, and/or changes to the total dollar amount oft the budget require a formal amendment. No adjustments to Contractor may request in writing up to a 5%i increase to the "Gross or Annual Salary" of ani individual employee ifa position currently listed in the contract becomes vacant and the newi incoming employee shall be hired at a higher or lower salary. Noi increase within the salary range is authorized without prior written approval from CDEC. Adding additional staff requires an amendment to the contract. Vacancy savings cannot be used to change salary amounts for existing personnel without an amendment. Any change toj personnel requires prior written approval from CDEC staff. This process shall never change the Contract Maximum Amount. Contractor must use available unused funds from either vaçancy savings or another category within the contract. The revision request may not at any time compromise the integrity oft the funded program as  thel Indirect Costs portion oft thel budget are allowable without ai formal amendment.  determined by CDEC program staff.  8. TRAVEL costs.  Travel costs must be listed in Exhibit B - Budget under travel including airfare, hotel, mileage and per diem A. Mileage shall not exceed thel Federal mileage rate per htps/wwvgsgov.ravel-resources  Page 2 of4  Revision Date 03/01/2023    COLORADO Department ofEarly Childhood  Exhibit D Amendment #5  B. Per Diem shall not exceed Federal GSA per diem rates for the area oft travel per C. Hotel rates cannot exceed any rate established: for conference attendance. D. Usage of airfare or Out of State Travel requires pre-approval from CDEC.  tps/ww.gsugov/ravel-resoures  9. SUBRECIPIENT  Contractors determined to be a Sub-recipient off federal funds shall complete the sub-recipient performance report and assessment survey at: htps/fomsgle/OTXGEabvipymdsrds upon contract execution. Failure to complete the performance report and assessment survey shall delay payment to the Contractor.  10. CRITICAL: INCIDENT REPORTING  Within 48 hours of the occurrence ofa critical incident involving any child or family and/or an on duty agency staff member of any family support program staff funded through the Department of Early Childhood (CDEC), the agency must report in writing the details oft the critical incident to the CDEC Program Manager for the involved family support program. Critical incidents may include, but are not limited to, awareness ofan egregious incident of abuse and/or neglect, neari fatality, or fatality of any child currently enrolled in a family support program; involuntary termination ofaj program staff's employment; criminal allegations involving program staff andi related to his/her employment; negative media attention about the family support program; any major injury or threat to the security of an agency staffmember while on duty and visiting an enrolled child  or family.  11. MANDATED REPORTING  A. Allj program staff are required by law to report suspected child abuse and neglect, Mandatory reporters must report suspected child abuse and neglect to the local county child welfare agency, thel local law enforcement agency, or by calling the child abuse reporting hotline system at 1-844-CO-4KIDS (1-844- B. All program staffa are required to take the online: mandatory reporter training on the Colorado Department ofHuman Services (CDHS) Child Welfare Training System: htps/ww.oloradoowiscom'mandatad.  264-5437).  reporter-training.  12. GIFTCARDS  Thel Distribution ofGift Cards, where applicable, shall adhere to the following:  A. The contractor agency must have a written Gift Card Distribution Policy inj place and this plan must bea approved by the Department of Early Childhood before gift cards may be purchased. Thej policy musti include maintaining an audit log of gift card purchases and disbursements and aj process for B. The contractor agency's gift card policy must ensure that gift cards cannot be redeemed for cash and must restrict the recipient from using gift cards for alcohol, firearms, tobacco, lottery tickets, or  routine reconciliations. entertainment.  Page 3of4  Revision Date 03/01/2023    COLORADO Department ofE Early Childhood  Exhibit D -Amendment #5  C. Gift Cards must be distributed to recipients within five (5) business days of purchase. D. Gift Cards should be given at the conclusion of an event or upon completion of an activity or E. Contractor agency staff shall have recipients sign a form thati includes the following: Date, Name of Gift Card Recipient, Purpose of Gift Card, Signature of Gift Card: recipient acknowledging receipt of F. The contractor cannot request reimbursement: fort the cost of gift cards until distribution oft the gift cards has been made to recipients. Additionally, the contractor must maintain adequate documentation to show ai record of all gift card distributions. G. The contractor shall be held responsible fori inappropriate use of gift cards.  milestone.  Gift Card and Gift Card Amount.  Page 4of4  Revislon' Date 03/01/2023    COLORADO Department ofE Early Childhood  EXHIBIT E-Amendment #5- Supplemental Provisions for Federal Awards  For the purposes oft this Exhibit only, Contractor is alsoi identifjed as Subrecipient." This Contract has been funded, in whole or inj part, with an award ofl Federal funds. Ini the event ofa conflict between the provisions of these Supplemental Provisions for Federal Awards, the Special Provisions, the Contract or any attachments or exhibits incorporated into and made aj part ofthe Contract, the Supplemental Provisions for Federal Awards shall control. Ini the event ofa conflict between the Supplemental: Provisions for Federal Awards and thel FFATA Supplemental: Provisions (ifany), and/or exhibit regarding SLFRF Federal Provisions, the terms rel FFATA and/or SLFRF shall control. Ift thes source oft the funding oft the Contract is a grant, these Federal Provisions are subject to the Award as definedi in $2 ofthese Federal Provisions, as may bei revised pursuant to ongoing guidance from the relevant Federal or State of Colorado agency or institutions of  higher education, 1) Federal Award Identification  i. Subrecipient: Prowers County Department of Human Services; ii. Subrecipient Unique Entity Identifier (UEI): number: Y8C4HSXY95M6; iii. The Federal Award Identification: Number (FAIN)is90Z.10036  iv. Thel Federal award date 09/07/2021; vi. Federal Funds:  V. Thes subaward period ofp performance start date is 09/30/2020 ande end datei is 09/29/2025;  Contract or Amount of] Federal funds Total amount of Federal Total amount ofthe  Fiscal Year obligated by this Contract funds obligated to the  Federal Award committed to Subrecipient by CDEC  Subrecipient $123,271  09/30/2023 09302023-09292024- 09302025-09292024 09302025-49292024  09/29/2024 $123,271  $123,271  vii. Federal award project description: Colorado Fatherhood FIRE Grant;  vii. The name of the Federal awarding agency is Department of Health and Human Services Administration for Children and! Families: The Office of Family Assistance; the name oft the pass-through entity is the State of Colorado, Department of Early Childhood (CDEC); and the contact information for the awarding ix. The Catalog of Federal Domestic. Assistance (CFDA) number is 93.086- - Healthy Marriage and Responsible Fatherhood, name is Colorado Fatherhood Program, and dollar amount is $1,495,808; xi. The indirect cost rate for thel Federal award (including ift the de minimis ratei is charged per 2 CFR $200.414 Indirect (F&A) costs) is pre-determined based upon the State of Colorado and CDEC cost allocation plan. 2) All requirements imposed by CDEC on Subrecipient so that thel Federal awardi is used: in accordance with Federal statutes, regulations, and thet terms and conditions of thel Federal award, are stated in the General Provisions and  official is Kendra Dunn;  X. This award is not for research & development;  Exhibit. A- Statement of Work, and Exhibit C-A Additional Provisions.  Supplemental Provisions for Federal Awards  Pagelof10  V2/(07-08-2022)    3) Any additional requirements that CDEC imposes on Subrecipient in order for CDEC to meeti its own responsibility to thel Federal awarding agency, including identification ofa any required financial andj performance: reports, are statedi in the General! Provisions and Exhibit. A - Statement of Work, and Exhibit C-4 Additional Provisions. 5) Subrecipient: must permit CDEC and auditors tol have access to Subrecipient's records and financial statements as necessary for CDEC to meet the requirements of2 CFR $200.331 Requirements for pass-through entities, 88 200.300 Statutory and National Policy Requirements through $200.309 Period of performance, and Subpart F--Audit 6) The: appropriate terms and conditions concerning closeout oft thes subaward are listed in Section 16 oft this Exhibit and the General Provisions and Exhibit A - Statement of Work, and Exhibit C- Additional Provisions. 7) Performance and Final Status. Subrecipient shall submit all financial, performance, and other reports to CDEC no later than 30 calendar days after thej period ofperformance end date or sooner termination oft this Contract containing ane evaluation andi review of Subrecipient's performance and the final status of Subrecipient's obligations hereunder.  4) Subrecipient's approved indirect cost rate is of 0%  Requirements oft this Part.  8) Matching) Funds i.  Ifal box below is checked, the acompanyingprovision applies. Subrecipient is not required toj provide matching funds.  Subrecipient shall provide matching funds as statedi ini insert reference to exhibit that contains match information. Subrecipient shalll have raised the full amount of matching funds prior tot the Effective Date and shall report to CDEC regarding the status ofs such funds upon request. Subrecipient's obligation toj pay all or any part ofany matching funds, whether direct or contingent, only extends toi funds duly and lawfully appropriated: for the purposes of this Contract by the authorized representatives oft the Subrecipient: and paid into the Subrecipient's treasury or bank account. Subrecipient represents to CDEC that the amount designated as matching funds has been legally appropriated for the purposes of this Contract by its authorized representatives and paid intoi its treasury or bank account. Subrecipient does not by this Contract irrevocably pledge present cash reserves for] payments in future fiscal years, and this Contract is noti intended to create a multiple-fiscal year debt ofthe! Subrecipient. Subrecipient shall not pay or be liable for any claimed interest, late charges, fees, taxes or penalties ofany nature, except as required by Subrecipient's laws or policies. 1.1. For the purposes of these Federal Provisions, the following terms shall have the meanings ascribed to them 1.1.1. "Award" means an award of Federal financial assistance, and the Contract setting forth the terms and conditions oft that financial assistance, thata a non-Federal Entity receives or administers.  1. DEFINITIONS.  below.  1.1.1.1.1. 1.1.1.1.2. 1.1.1.1.3. 1.1.1.1.4. 3710); 1.1.1.1.5. 1.1.1.1.6. 1.1.1.1.7. 1.1.1.1.8.  Awards may be in the form of:  Grants; Contracts;  Cooperative Contracts, which do not include cooperative research and development Contracts (CRDA). pursuant to the Federal Technology Transfer Act of 1986, as amended(ISU.S.C.  Loans; Loan Guarantees; Subsidies; Insurance;  Supplemental) Provisions for Federal Awards  Page 2of1 10  V2( (07-08-2022)    1.1.1.1.9.  Food commodities;  1.1.1.1.10. Direct appropriations; non-Federal Entities, other source posted by the OMB.  1.1.1.1.11. Assessed and voluntary contributions; and  1.1.1.1.12. Other financial assistance transactions that authorize the expenditure of Federal funds by 1.1.1.1.13. Any other items specified by OMB inj policy memoranda available at the OMB website or  1.1.1.2. 1.1.1.2.1. 1.1.1.2.2. isc calleda a grant; 1.1.1.2.3. 1.1.1.2.4.  Award does noti include;  Technical assistance, which provides services in lieu of money;  At transfer oftitle tol Federaly-owned property provided in lieu ofmoney; eveni ifthe award Any award funded in whole or in part with Recovery funds, as defined in section 1512of  Any award classified for security purposes; or  the American Recovery and Reinvestment Act (ARRA)of2009 (Public Law 111-5).  1.1.2. "Contract" means the Contract to which these Federal Provisions are attached and includes all Award types 1.1.3. "Contractor" means the party or parties to a Contract funded, in whole or in part, with Federal financial assistance, other than the Prime Recipient, and includes grantees, subgrantees, Subrecipients, and borrowers. For purposes ofTransparency Act reporting, Contractor does noti include Vendors. 1.1.4. "Data Universal Numbering System (DUNS) Number" means the nine-digit number established and assigned by Dun and Bradstreet, Inc. to uniquely identify a business entity. Dun and Bradstreet's website  ins oft this Exhibit.  may be: found at: ittp./fedgoy.dmb.com/webform.  1,1.5. "Entity": means: 1.1.5.1.  Ifthe source of funding is a Grant: 1.1.5.1.1. al Non-Federal Entity; 1.1.5.1.2. af foreign public entity; 1.1.5.1.3. aforeign organization; 1.1.5.1.4. anon-profit organization;  1.1.5.1.5. a domestic for-profit organization (for 2CFR parts 25 and 170 only); 1.1.5.1.6. aforeign non-profit organization (only for2 CFR part 170) only); 1.1.5.1.7. al Federal agency, but only as a Subrecipient under an Award or Subaward toa 1.1.5.1.8, af foreign for-profit organization (for 2 CFR part 170 only). 1.1.5.2.1. all oft thei following as defined at 2CFR part 25, subpart C;  non-Federal entity (or2CFR 200.1); or Ifthe source of funding is not a Grant:  1.1.5.2.  1.1.5.2.2. A governmental organization, which is a State, local government, or Indian' Tribe;  1.1.5.3. af foreign public entity;  1.1.5.4. ac domestic or foreign non-profit organization; 1.1.5.5. ac domestic or foreign for-profit organization; and  Supplemental Provisions for Federal Awards  Page3of10  V2(07-08-2022)    1.1.5.6. aF Federal agency, but only a Subrecipient under an Award or Subaward to ai non-  Federal entity.  1.1.6. "Executive" means an officer, managing partner or any other employee in a management position. 1.1.7. If the source of funding is a Grant, "Federal Awarding Agency" means a Federal agency providing a Federal. Award to al Recipient as describedi in 2CFR: 200.1. Ifthes source off funding is nota a Grant, "Federal Award Identification Number (FAIN)" means an Award number assigned by a Federal agency to al Prime 1.1.8. "FFATA" means thel Federall Funding Accountability and' Transparency. Acto of2006 (Public Law 109-282), as amended by $6202 ofPublic] Law 110-252. FFATA, as amended, alsoi is referred to as the" Transparency 1.1.9. "Federal Provisions" means these Federal Provisions subject to the Transparency Act and Uniform Guidance, as may be revised pursuant to ongoing guidance from the relevant Federal or State of Colorado 1.1.10. Ifthes source of funding is a Grant, "Grant" as used) herein is the Contract to which these Federal Provisions 1.1.11. "Grantee" means thej party or parties identified as such in the Grant to which these Federal Provisions are 1.1.12. "Non-Federal Entity means a State, local government, Indian tribe, institution of higher education, or nonprofit organization that carries out al Federal Award as al Recipient or a Subrecipient. 1.1.13. "Nonprofit Organization" means any corporation, trust, association, cooperative, or other organization, not  Recipient. Act."  agency or institutions ofhigher education.  are attached.  attached ift the source of funding is a Grant.  including IHES, that:  1.1.13.1. Is operated primarily for scientific, educational, service, charitable, or similar purposes in the 1.1.13.3. Uses net proceeds tor maintain, improve, or expand the operations oft the organization. 1.1.14. "OMB" means thel Executive Office oft thel President, Office ofManagement andl Budget. 1.1.15. Pass-through Entity" means a non-Federal Entity that provides a Subaward to a Subrecipient to carry out 1.1.16. "Prime Recipient" means a Colorado State agency or institutiono ofhigher education that receives an Award, or, of thes source of funding is a Grant iti is that agency or institution identified as the Grantor in the Grant 1.1.17. "Subaward" means an awardl by al Prime Recipient to a Subrecipient funded in whole ori inj part by al Federal Award. The terms and conditions oft thel Federal Award flow down to the Subaward unless thet terms and conditions of the Federal Award specifically indicate otherwise in accordance with 2 CFR 200.101 or 2 CFR200.38, as applicable. Thet termo doesn not include payments to a contractor or payments to ani individual 1.1.18. Subrecipient" or, ifthes source offundingi isaG Grant, "Subgrantee" meansan non-Federal Entity (oraF Federal agency under an Award or Subaward to a non-Federal Entity) receiving Federal funds through a Prime Recipient to support the performance of the Federal project or program for which the Federal funds were awarded.. A Subrecipient: iss subject tot the terms and conditions of the! Federal Award tot thel Primel Recipient, including program compliance requirements. The term "Subrecipient" includes and may be referred to as Subgrantee. The term does noti include an individual who is al beneficiary ofai federal program. 1.1.19. "Subrecipient Parent. DUNSI Number" means thes subrecipient parent organization's9 9-digit Data Universal Numbering System (DUNS) number that appears in the subrecipient's System for Award Management  public interest;  1.1.13.2. Is not organized primarily for profit; and  part ofal Federal program.  to which these Federal Provisions are attached.  thati is al beneficiary ofal Federal program.  (SAM) profile, if applicable.  Supplemental. Provisions for Federal. Awards  Page4 40 of10  V2( (07-08-2022)    1.1.20. "System for Award Management (SAM)" means thel Federal repository into which an Entity must enter the information required under the Transparency Act, which may be found atl htp/www.sam.gov. 1.1.21. "Total Compensation" means the cash and noncash dollar value earned by an Executive during thel Prime Recipient's or Subrecipient's preceding fiscal year (see 48 CFR 52.204-10, as prescribed in 48 CFR 1.1.21.2. Awards of stock, stock options, and stock appreciation rights, using the dollar amount  4.1403(a), as applicable) and includes the following:  1.1.21.1.  Salary and bonus;  recognized for financial statement reporting purposes with respect to the fiscal year in accordance with the Statement of Financial Accounting Standards No. 123 (Revised 2005) hospitalization or medical reimbursement plans that do not discriminate ini favor ofExecutives Change inj present value of defined' benefit and actuarial pension plans; Above-market earnings on deferred compensation which is not tax-qualified; termination payments, value of life insurance paid on behalf of the employee, perquisites or  (FAS 123R), Shared Based Payments;  1.1.21.3. Earnings for services under non-equity incentive plans, not including group life, health,  and are available generally to all salaried employees;  1.1.21.4. 1.1.21.5.  1.1.21.6. Other compensation, if the aggregate value of all such other compensation (e.g-, severance,  property): for the Executive exceeds $10,000.  1.1.22. "Transparency Act" means the Federal Funding Accountability and' Transparency Act of2006 (Public Law 109-282), as amended' by $6202 of Public) Law 110-252. The Transparency Act may also be referred to as 1.1.23. "Uniform Guidance": means the Office ofManagement and Budget Uniform Administrative. Requirements, Cost] Principles, and Audit Requirements for Federal Awards, which, unless thes soureoffumaingisaGam, supersedes requirements from OMB Circulars A-21, A-87, A-110, and A-122, OMB Circulars A-89, A- 102, and A-133, and the guidance in Circular A-50 on Single Audit Act follow-up. The terms and conditions of the Uniform Guidance flow down to. Awards to Subrecipients unless the Uniform Guidance 1.1.24. "Vendor" means a dealer, distributor, merchant or other seller providing property or services required for a project or program funded by an Award. A Vendor is not a Prime Recipient or a Subrecipient and is not subject to the terms and conditions of the Federal award. Program compliance requirements do not pass  FFATA.  or the terms and conditions oft the Federal Award specifically indicate otherwise.  through to a Vendor.  2. COMPLIANCE.  2.1. Contractor/Grantee shall comply with all appliçable provisions of the Transparency Act and the regulations issued pursuant thereto, all applicable provisions of the Uniform Guidance, including, but not limited to, all applicable Federal Laws and regulations required by this Federal Award. Any revisions to such provisions or regulations shall automatically become ap part oft these Federal Provisions, without the necessity ofe either party executing any further instrument. The State of Colorado, at its discretion, may provide written notification to Contractor/Grantee of such revisions, but such notice shall not be a condition precedent to the effectiveness of  such revisions. REQUIREMENTS.  3. SYSTEM: FOR AWARD MANAGEMENT (SAM). ANDI DATA UNIVERSALI NUMBERING: SYSTEM (DUNS) 3.1. SAM. Contractor/Grantee shall maintain the currency of its information in SAM until the Contractor/Grantee submits the final financial report required under the Award or receives final payment, whichever is later. Contractor/Grantee shall review and update SAM information at least annually after the initial registration, and  more frequently ifr required by changes ini its information.  Supplemental Provisions for Federal Awards  Page5of10  V2/(07-08-2022)    3.2. DUNS, Contractor/Grantee shall provide its DUNS number to its Prime Recipient, and shall update Contractor's/Grantee'sinformation: in Dun & Bradstreet, Inc. atl least annually after thei initial registration, and  more frequently ifrequired by changes in Contractor/Grante'si information.  4. TOTALCOMPENSATION.  4.1. Contractor/Grantee shall include Total Compensation in SAM for each of its five most highly compensated 4.1.1. Thei total Federal funding authorized to date under the Award is $30,000 or more if the source of funding 4.1.2.1. 80% or more of its annual gross revenues from Federal procurement contracts and subcontracts and/or Federal financial assistance Awards or Subawards subject to the Transparency Act; and 4.1.2.2. $30,000,000 or more in annual gross revenues from Federal procurement contracts and subcontracts and/or Federal finançial assistance. Awards or Subawards subject to the' Transparency Act ift the source offunding is a Grant or otherwise $25,000,000 or more: in annual gross revenues from Federal procurement contracts and subcontracts and/or Federal financial assistance Awards or Subawards subject tot the Transparency Acti ift the source of funding is not a Grant; and 4.1.2.3. Thej public does notl have access to: information about the compensation of such Executives through periodic reports filed under section 13(a) or 15(d) of the Securities Exchange Act of 1934 (15  Executives for the preceding fiscal year if:  isa Grant, or otherwise $25,000 or more ift thes source of funding is not a Grant; and  4.1,2. In thej preceding fiscal year, Contractor/Grantee: received:  U.S.C. 78m(a), 78o(d) or S 6104 oft the Interal Revenue Code of1986.  5. REPORTING.  5.1. IfContractor/Grantee is a Subrecipient of the Award pursuant to the Transparency Act, Grantee shall report data elements to SAM andt to thel Prime Recipient as required in this Exhibit. No direct payment shall be made to Grantee for providing any reports required under these Federal Provisions and the cost of producing such reports shall be included in the Contract/Grant price. The reporting requirements in this Exhibit are based on guidance from thel US Office of Management and Budget (OMB), and as such are subjectt to change at anyt time by OMB. Any such changes shalll be automatically incorporated: into this Contract/Grant: and shalll become part  ofCOntractorGnante'se obligations under this Contract/Grant. EFFECTIVE. DATE. ANDI DOLLAR' THRESHOLD FORI REPORTING.  6.1. Ifthe source of funding is a Grant, Reporting requirements in $8 below apply to new Awards as of October 1, 2010, if the initial award is $30,000 or more. If the initial Award is below $30,000 but subsequent Award modifications result in a total Award of$30,000 or more, the Awardi is subject to the reporting requirements as of the date the Award exceeds $30,000. Ifthe initial Award is $30,000 or more, but funding is subsequently de-obligated such that the total award amount falls below $30,000, the Award shall continue to be subject to 6.2. Ift thes source ofi funding is not a Grant, Reporting requirements in $81 below apply to new Awards as of October 1,2010, ift thei initial award is $25,000 or more. Ift the initial Award is below $25,000 but subsequent Award. modifications resulti ins at total Award of$25,000 or more, the Award is subject to thet reporting requirements as of the date the Award exceeds $25,000. Ifthe initial. Award is $25,000 or more, but funding is subsequently de-obligated such that the total award amount falls below $25,000, the Award shall continue to be subject to 6.3. Thej procurement standards in $81 below are applicable to new Awards made byl Primel Recipient as ofDecember 26, 2015. The standards set forth in $10 below are applicable to audits of fiscal years beginning on or after  the reporting requirements.  the reporting requirements. December 26, 2014.  7. SUBRECIPIENT REPORTING REQUIREMENIS.  7.1. Contractor/Crantee is a Subrecipient, Contractor/Grantee shall report as set forth below.  Supplemental Provisions for Federal Awards  Page 6of10  V2(07-08-2022)    7.1.1. To SAM. A Subrecipient shall register in SAM and report the following data elements in SAM for each Federal Award dentification Number (FAIN) assigned by al Federal agency to a Prime Recipient no later 7.1.1.2. Subrecipient DUNS Numberi if more than one electronic funds transfer (EFT) account; 7.1.1.4. Subrecipient's address, including: Street Address, City, State, Country, Zip (+4if source of 7.1.1.5. Subrecipient's top 5 most highly compensated Executives ift the criteria in $4 above are met; 7.1.1.6. Subrecipient'sTotal Compensation of top 5most highly compensated. Executives ift the criteria 7.1.2. To Prime Recipient. A Subrecipient shall report to its Prime Recipient, upon the effective date of the  than the end oft the month following the month in which the Subaward was made:  7.1.1,1. Subrecipient DUNS Number;  7.1.1.3. Subrecipient parent's organization DUNS Number;  funding is a Grant or as otherwise directed per SAM directives for proper reporting), and  Congressional District; and in $4 above1 met.  Contract/Grant, the following data elements: 7.1.2.1. Subrecipient's DUNS Number as registered in SAM.  7.1.2.2. Primary Place ofl Performance Information, including: Street Address, City, State, Country, Zip  code +4, and Congressional District.  8. PROCUREMENT STANDARDS.  8.1. Procurement Procedures. A Subrecipient shall use its own documented procurement procedures which reflect applicable State, local, and Tribal laws and applicable regulations, provided that the procurements conform to applicable Federal law and the standards identified in the Uniform Guidance, including without limitation, 2 8.2. Ift the source of funding is a Grant: Domestic preference for procurements (2 CFR 200.322). As appropriate and to the extent consistent with law, the non-Federal entity should, to the greatest extent practicable under a Federal award, provide a preference for the purchase, acquisition, or use of goods, products, or materials produced in the United States (including but not limited to iron, aluminum, steel, cement, and other manufactured products). The requirements of this section must be included in all subawards including all 8.3. Procurement of Recovered Materials. Ifa Subrecipient is a State Agency or an agency ofap political subdivision ofthe State, its contractors must comply with section 6002 oft the Solid Waste Disposal Act, as amended by the Resource Conservation and Recovery Act. The requirements of Section 6002 include procuring only items designated in guidelines of the Environmental Protection Agency (EPA) at 40 CFR part 247, that contain the highest percentage of recovered materials practicable, consistent with maintaining a satisfactory level of competition, where the purchase price ofthei item exceeds $10,000 or the value oft the quantity acquired during the preceding fiscal year exceeded $10,000; procuring solid waste management services in a manner that maximizes energy andr resource: recovery; ande establishing an affirmativep procurement program for procurement  CFR2 200.3181 through 200.327 thereof.  contracts and purchase orders for work or products under this award.  ofrecovered: materials identified in the EPA guidelines.  9. ACCESS TO RECORDS.  9.1. A Subrecipient shall permit Recipient/Prime Recipient andi its auditors tol have access to Subrecipient's records and financial statements as necessary for Recipient to meet the requirements of 2 CFR 200.311-200.332 (Requirements for pass-through entities), 2 CFR 200.300 (Statutory and national policy requirements) through 2CFR:200.309 (Period of performance), and Subpart F-Audit Requirements oft the Uniform Guidance.  10. SINGLE. AUDIT REQUIREMENTS. Supplemental: Provisions for Federal. Awards  Page7of10  V2( (07-08-2022)    10.1. Ifa Subrecipient expends $750,000 or more in Federal Awards during the Subrecipient's fiscal year, the Subrecipient shall procure or arrange for a single or program-specific audit conducted for that year in accordance with the provisions of Subpart F-Audit Requirements oft the Uniform Guidance, issued pursuant to 10.1.1. Election. A Subrecipient shalll have a single audit conducted in accordance with Uniform Guidance 2 CFR 200.514 (Scope ofaudit), except when ite elects tol have aj program-specific audit conducted in accordance with 2 CFR 200.507 (Program-specific audits). The Subrecipient may elect to have a program-specific audit if Subrecipient expends Federal Awards under only one Federal program (excluding research and development) and the Federal program's statutes, regulations, or the terms and conditions of the Federal award do not require a financial statement audit of Prime Recipient. Aj program-specific audit may not be elected for research and development unless all of the Federal Awards expended were received from 10.1.2. Exemption. Ifa Subrecipient expends less than $750,000 in Federal Awards during its fiscal year, the Subrecipient shall be exempt from Federal audit requirements for that year, except as noted in 2 CFR 200.503 (Relation to other audit requirements), but records shall be available for review or audit by appropriate officials of thel Federal agency, the State, and the Government Accountability Office. 10.1.3. Subrecipient Compliance Responsibility. A Subrecipient shall procure or otherwise arrange for the audit required by Subpart F of the Uniform Guidance and ensure iti is properly performed and submitted when duei in accordance withi thel Uniform Guidance. Subrecipient shall prepare appropriate financial statements, including the schedule of expenditures of Federal awards in accordançe with 2 CFR 200.510 (Financial statements) and provide the auditor with access to personnel, accounts, books, records, supporting documentation, and other information as needed for the auditor to perform the audit required by Uniform  the Single. Audit Act. Amendments of1 1996, (31U.S.C. 7501-7507). 2CFR2 200.501.  Recipient and Recipient approves in advance a program-specitic audit.  Guidance Subpart F-Audit Requirements.  11. CONTRACT/GRANTPROVISIONS FOR SUBRECEPIENT CONTRACTS.  11.1. In addition to other provisions required by the Federal Awarding Agency or the Prime Recipient, Contractors/Orantees: that are Subrecipients shall comply with the following provisions. Subrecipients shall include all of the following applicable provisions in all subcontracts entered into by it pursuant to this 11.1.1. [Applicable to federally assisted construction contracts.] Equal Employment Opportunity. Except as otherwise provided under 41 CFR Part 60, all contracts that meet the definition of "federally assisted construction contract" in 41 CFR Part 60-1.3 shall include the equal opportunity clause provided under 41 CFR 60-1.4(b), in accordance with Executive Order 11246, "Equal Employment Opportunity" (30 FR 12319, 12935,3CFRI Part, 1964-1965 Comp., p.3 339), as amended byl Executive Order 11375," "Amending Executive Order 112461 Relating to Equal Employment Opportunity," and implémenting regulations at 41 CFR part 60, Office of Federal Contract Compliance Programs, Equal Employment Opportunity, 11.1.2. [Applicable to on-site employees working on govemment-funded construction, alteration and repair 11.1.3. Rights to Inventions Made Under a contract/grant or agreement. Ifthel Federal Award meets the definition of "funding agreement" "funding Contract" under 37 CFR 401.2 (a) and the Prime Recipient or Subrecipient wishes to enteri into a contract with a small business firm or nonprofit organization regarding the substitution of parties, assignment or performance of experimental, developmental, or research work under that "funding agreement,"/-lundingi Contract", thel Primel Recipient or Subrecipient must comply with the requirements of37 CFR. Part 401, "Rights tol Inventions Made by Nonprofit Organizations and Small Business. Firms Under Govemment Grants, Contracts and Cooperative. Agreements," and anyi implementing  Contract/Grant.  Department ofLabor.  projects.] Davis-Bacon Act. Davis-Bacon Act, as amended (40 U.S.C. 3141-3148).  regulations issued by the Federal. Awarding Agency.  Supplemental Provisions for Federal. Awards  Page 8of10  V2(07-08-2022)    11.1.4. Clean Air Act (42 U.S.C. 7401-7671q.) and the Federal Water Pollution Control Act (33 U.S.C. 1251- 1387), as amended. Contracts and subgrants ofamounts in excess of $150,000 must contain aj provision that requires the non-Federal awardee(s) to agree to comply with all appliçable standards, orders or regulations issued pursuant to the Clean Air Act (42 U.S.C. 7401-7671q) and the Federal Water Pollution Control Act as amended (33 U,S.C. 1251-1387). Violations must be reported to the Federal Awarding 11.1.5. Debarment and Suspension (Executive Orders 12549 and 12689). A contract award (see 2 CFR 180.220) must not be made toj parties listed on the government wide exclusions in the System for Award) Management (SAM), in accordance with the OMB guidelines at 2 CFR 180 that implement Executive Orders 12549 (3 CFR part 1986 Comp., p. 189) and 12689 (3 CFR part 1989 Comp., p. 235), "Debarment and Suspension." SAM Exclusions contains the names of parties debarred, suspended, or otherwise excluded by agencies, as well as parties declared 11.1.6. Byrd. Anti-Lobbying. Amendment (31 U.S.C. 1352). Contractors that apply or bid for an award exceeding $100,000 must filet the required certification. Each tier certifies to thet tier above thati it will not and! has not usedI Federal appropriated funds toy paya any person or organization: fori influencing or attempting toi influence an officer or employee of any agency, a member of Congress, officer or employee of Congress, or an employee ofai member of Congress in connection with obtaining any Federal contract, grant or any other award covered by 31 U.S.C. 1352. Each tier must also disclose any lobbying with non-Federal funds that takes place in connection with obtaining any Federal award. Such disclosures are forwarded from tier to 11.1.7. Never contract with the enemy (2 CFR2 200.215). Federal awarding agencies and recipients are subject to the regulations implementing "Never contract with the enemy" in 2 CFR part 183. The regulations in 2 CFR part 183 affect covered contracts, grants and cooperative agreements that are expected to exceed $50,000 within thej period of performance, are performed outside the United States and its territories, and are in support ofa contingency operation in which members of the Armed Forces are actively engaged in 11.1.8. Prohibition on certain telecommunications and video surveillance services or equipment (2 CFR 200.216). Grantee is prohibited from obligating or expending loan or grantf funds on certain telecommunications and  Agency and the Regional Office ofthel Environmental Protection Agency (EPA).  ineligible under statutory or regulatory authority other than Executive Order 12549.  tier up to the non-Federal award.  hostilities.  video surveillance services or equipment pursuant to 2 CFR 200.216.  12. CERTIFICATIONS.  12.1. Unless prohibited by Federal statutes or regulations, Recipient/Prime Recipient may require Subrecipient to submit certifications andi representations required by Federal statutes or regulations on an annual basis. 2CFR 200.208. Submission may bei required more fiequemtylfSabreipiem: failst to meet ai requirement ofthe Federal award. Subrecipient shall certifyi in writing to the State at the end of the Award that the project or activity was completed or the level ofeffort was expended. 2CFR: 200.201(3). Ifthe required level of activity or effort was  not carried out, the amount of the Award must! be adjusted.  13. EXEMPTIONS.  13.1. These Federall Provisions do not apply tos an individual who receives an Award as a natural person, unrelated to any business or non-profit organization he or she may own or operate in his or her name. 13.2. A Contractor/Grantee with gross income from all sources of less than $300,000 in the previous tax year is exempt from the requirements to report Subawards and the Total Compensation ofits most highly compensated  Executives.  14. EVENT OF DEFAULT. AND TERMINATION.  14.1. Failure to comply with these Federal Provisions shall constitute an event of default under the Contract/Grant and the State of Colorado may terminate the Contract/Grant upon 30 days prior written notice if the default remains uncured five calendar days following the termination oft the 30-day notice period. This remedy will be ina addition to any other remedy available to the State ofColorado under the Contract/Grant, atl law ori in equity. 14.2. Termination (2 CFR: 200.340). The Federal Award may be terminated in whole ori in part as follows:  Supplemental Provisions for Federal Awards  Page 9of10  V2(07-08-2022)    14.2.1. By thel Federal Awarding Agency or Pass-throughl Entity, ifal Non-Federal Entity fails to comply with the 14.2.2. By thel Federal awarding agency or Pass-through Entity, tot the greatest extent authorized byl law,i ifana award 14.2.3. By the Federal awarding agency or Pass-through Entity with the consent of the Non-Federal Entity, in which case thet two parties must agree upon the termination conditions, including the effective date and, in 14.2.4. By the Non-Federal Entity upon sending to the Federal Awarding Agency or Pass-through Entity written notification setting forth the reasons for such termination, the effective date, and, in the case of partial termination, the portion tol bei terminated. However, ifthel Federal Awarding Agency or Pass-through) Entity determines int the case of partial termination that the reduçed or modified portion oft the Federal Award or Subaward will not accomplish the purposes for which thel Federal Award was made, the Federal Awarding 14.2.5. Byt the Federal Awarding Agency or Pass-throughl Entity pursuant to termination provisionsi includedi in the  terms and conditions ofal Federal Award;  no longer effectuates thej program goals or agency priorities; the case ofpartial termination, thej portion to be terminated;  Agency or Pass-through Entity may terminate the Federal Award in its entirety; or  Federal. Award.  EXHIBIT END  Supplemental. Provisions for Federal Awards  Page 10of10  V2(07-08-2022)    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Datel Requested: June 13,2023 Submitter: Meagan Hillman, PCPHE Director  Submitted to the County Administration Office on: 06/01/2023 Return Originals to: Meagan Hillman PCPHE Director Number of originals to return to Submitter: 1  Contract Due Date: ASAP  Item Tite/Recommended Board Action:  Consider approval of Master Task Order Contract No. 23 FAA 00042, Task Order No. 2024*0719, FY 2024-2027, funding amount $331,314.00 for OPHP and authorizing Meagan  Hillman, PH Director to execute the document electronically.  Justification or Background: This is funding from OPHP via CDC for infrastructure funding in  the amount of $331,314 for FY 24-27  Fiscal Impact: This item is budgeted in the following account code:  County: $  Federal: $  State: $  Other: $  Approved by the County Attorney on:    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested: June 13, 2023 Submitter: Meagan Hillman, PCPHE Director  Submitted to the County Administration Office on: 06/01/2023 Return Originals to: Meagan Hillman PCPHE Director Number of originals to return to Submitter: 1  Contract Due Date: ASAP  Item Title/Recommended Board Action:  Consider approval of Master Task Order Contract No. 23 FAA 00042, Task Order No. 2024*0719, FY 2024-2027, funding amount $331,314.00 for OPHP and authorizing Meagan  Hillman, PH Director to execute the document electronically.  Justification or Background: This is funding from OPHP via CDC for infrastructure funding in  the amount of $331,314 for FY2 24-27  Fiscal Impact: This item is budgeted in the following account code:  County: $  Federal: $  State: $  Other: $  Approved by the County Attorney on:    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested: June 13, 2023 Submitter: Meagan Hillman, PCPHE Director  Submitted to the County Administration Office on: 06/01/2023 Return Originals to: Meagan Hillman PCPHE Director Number of originals to return to Submitter: 1  Contract Due Date: ASAP  Item Title/Recommended Board Action:  Consider approval ofl Master Task Order Contract No. 23 FAA 00042, Task Order No. 2024*0719, FY 2024-2027, funding amount $331,314.00 for OPHP and authorizing Meagan  Hillman, PH Director to execute the document electronically.  Justification or Background: This is funding from OPHP via CDC for infrastructure funding in  the amount of $331,314 for FY 24-27  Fiscal Impact: This item is budgeted in the following account code:  County: $  Federal: $  State: $  Other: $  Approved by the County Attorney on:    DocuSign Envelope ID:  TASK ORDER  State. Agency State ofColoradoi for the use & benefit oft the Department ofl Public Health andl Environment 4300 Cherry Creek Drive South Denver CO 80246  Contractor Board of County Commissioners ofl Prowers County (aj political subdivision oft thes state of Colorado) 301 South Main Street, #215 Lamar CO 81052 for the use and benefit ofthe Prowers County Public Health 1001 South) Main Street Lamar CO 81052-3838 Task Order Performance Beginning Date The. later oft the' Task Order Effective Date or. July 1, 2023  Master Task Order Contract Number 23 FAA 00042 Task Order Number 2024*0719 Task Order Maximum Amount Initial Term State Fiscal Year 2024 Total for All State Fiscal Years Pricing/Funding Price Structure: Fixed) Price Contractor Shall Invoice: Once Funding Source: Federal State Representative Michele Shimomura Director Planning, andl Local Partnerships 4300 Cherry Creek Drive South Denver, CO 80246 Michele.Shimomura@state.co.us Exhibits and Order of Precedence  Task Order Expiration Date November 30, 2027  $331,314.00 $331,314.00  Except as stated in $2.D., the total duration oft this Contract, including the exercise of any options to extend, shall not exceed 5 years fromi its Performance Authority to enteri intot this Contract exists in: C.R.S. 25-1.5-101 - C.R.S. 25-1.5-113 Law Specified Vendor Statute (ifany): Not Applicable Procurement Method: Exempt Solicitation Number (if any): Not Applicable Contractor Representative Meagan Hillman Public Health Director 1001 Southl Main Street Lamar CO 81052-3838 lmamgpowerounyat  Beginning Date. Miscellaneous:  $331,314.00  Administration Division, Office of Public Health Practice, Prowers County Public Health  Colorado Department of Public Health and Environment  The following Exhibits and attachments are included with this Contract:  Exhibit. A Additional Provisions Exhibit B Statement of Work Exhibit CE Budget Exhibit DI Federal Provisions Contract Purpose  To advance Colorado's public health workforce capacity through public health transformation by strengthening  partnerships and building resilience among Colorado's public! health workforce.  Task Order Number: 2024*0719  Page 1 of 3Version 02.24.2022    DocuSign Envelope ID:  Ina accordance with $4.B oft thel Master Task Order Contract referenced above, Contractor shall complete the  following Project: 1.1 PROJECT DESCRIPTION  Contractor shall complete the Project described in Exhibit B Statement of Work (SOW) that is attached hereto and incorporated herein ("the SOW"). All terminology used int this Task Order and the Statement of Work shall be interpreted in accordance with the Master Task Order Contract unless specifically defined differently in this Task Order, The Statement of Work and Budget are incorporated herein, made aj part hereof and attached hereto The State shall pay Contractor the amounts shown in Exhibit C- Budget thati is attached hereto andi incorporated herein, in accordance with the requirements of the Statement of Work andt the Master Task Order Contract. The State shall not make any payment for a State Fiscal Year that exceeds the' Task Order Maximum Amount: shown Contractor shall complete all Work ont the Project described in this" Task Order byt the Task Order Expiration! Date stated above. Contractor shall not perform any Work describedi ini the Statement of Work prior tot the' Task Order Thel Effective Date ofthis" Task Order is upon approval oft the State Controller or July 1,2023, whichever isl later.  asl Exhibit B Statement of Work and Exhibit C- Budget.  2. PAYMENT  above for that State Fiscal Year. 3. PERFORMANCE PERIOD  Performance Beginning Date or after the' Task Order Expiration Date stated above.  4. TASK ORDER EFFECTIVE DATE:  Task Order Number:2024*0719  Page 2 of 3Version 02.24.2022    DocuSign Envelope ID:  THE PARTIES HERETO HAVE EXECUTED THIS CONTRACT Each person signing this Contract represents and warrants that he or shei is duly authorized to execute this Contract and to bind the Party authorizing his or her signature.  STATE OF COLORADO Jared S. Polis, Governor Colorado Department of Public Health and Environment Jill Hunsaker Ryan, MPH, Executive Director  CONTRACTOR Board of County Commissioners of] Prowers County (a political subdivision of the state of Colorado) for the use: and benefit oft the Prowers County Public Health  By: Signature  By: Signature  Meagan Hillman Director  Name of] Executive Director Delegate Title of Executive Director Delegate  Name of] Person Signing for Contractor Title of] Person Signing for Contractor  Date:  Date:  Ina accordance with $24-30-202, C.R.S., this Option is not valid until signed and dated below byt the State Controller or an  authorized delegate. STATE CONTROLLER Robert. Jaros, CPA, MBA,JD  By: Signature  Name of State Controller Delegate Title of State Controller Delegate  Effectivel Date:  --Signature Page End--  Task Order Number: 2024*0719  Page 3of3  Version 02.24.2022    DocuSign Envelope ID: FE340F86-E673-44EA-BFF0-9F2E2F207759  EXHIBIT. A  ADDITIONAL PROVISIONS  Tol Master Task Order Contract Dated 7/1/2022 Task Order Routing Number 2024*0719 These provisions aret tol be read and interpreted in conjunction with the provisions oft the Master" Task Order Contract  specified above.  1.  Time Limit For Acceptance OfDeliverables.  a. b.  Evaluation. Period. The State shall have 14 calendar days from the date a deliverable is delivered tot the State by the Contractor to evaluate that deliverable, except for those deliverables that havea a Notice ofl Defect. Ifthe State believes ing good faith that a deliverable fails to meett the design specifications for that particular deliverable, ori is otherwise deficient, then the State shall notify the Contractor oft the failure or deficiencies, in writing, within 14 calendar days of: 1)the date the deliverable is delivered to1 the State by the Contractor ifthe State is aware oft the failure or deficiency att the time ofc delivery; or 2)t the date the State becomes aware oft the failure or deficiency. The abovet 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 Time to Correct Defect. Upont receipt of timely written notice of an objection to a completed deliverable, the Contractor shalll have a reasonable period oft time, not to exceed 14 calendar days, to correct the noted deficiencies. Ifthe Contractor fails to corrects such deficiencies within 14 calendar days, the Contractor shall be in default ofi its obligations under this Task Order Contract  different time negotiated byt the State andt the Contractor.  fiscal rules.  C.  andt the State, ati its option, may elect to terminate this Task Order.  2.  Contractor shall request prior approval in writing from the State for all modifications toi the Statement of Work/Work Plan, or for any modification tot the direct costs in excess oftwenty-five percent (25%) ofthe total budget for direct costs, or for any modifications to the indirect cost rate. Any request for modifications tot thel Budget in excess oftwenty-five percent (25%) oft thet total budget for direct costs, or any modifications toi indirect cost rates, shall bes submitted tot the State at least ninety (90) days prior tot the end oft the contract period and will require a modifiçation in accordance with General Provisions, Section The Contractor shall comply with allowability of expenditures as listed in the CDPHE OPHP CDC Infrastructure Allowability Roadmap; Allowable costs for funding source can be found on the following CDPHE reserves the right tor request funds be returned to CDPHE ifthe Contractor misuses the funds according to the CDPHE CDCI Infrastructure Allowability Roadmap. Misuse includes international travel Coronavirus Disease 2019 (COVID-19): Funds A recipient ofa grant or cooperative agreement awarded by the Department ofHealth and Human Services (HHS) with funds made available under the Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 (P.L. 116-123); the Coronavirus Aid, Relief, and Economic Security Act, 2020 (the "CARES. Act") (P.L. 116-136); the! Paycheck Protection Program and Health Care Enhancement Act (P.L. 116-139); and/or the Consolidated. Appropriations Act  16, Contract Modifications, or Option Letter Provisions oft this Contract. website: htps/edphe-pha.cola-olonadngoviemirasincture-phas  3.  expenses.  4.  Task Order Number: 2024*0719  Page 1 of2  Version 04.15.2022    DocuSign Envelope ID:  and the Coronavirus Response and Relief Supplement Appropriations Act, 2021 (P.L. 116-260) and/or the American Rescue Plan of 2021 [P.L. 117-2] agrees as applicable tot the award, to: 1) comply with existing and/or future directives and guidance from the Secretary regarding control of thes spread of COVID-19;2) in consultation and coordination with] HHS, provide, commensurate with the condition oft thei individual, COVID-19 patient care regardless of thei individual's homej jurisdiction and/or appropriate public! health measures (e.g, social distancing, orl home isolation); and 3) assist the United States Government int the implementation and enforcement of federal orders relatedi to quarantine andi isolation. In addition, tot the extent applicable, Recipient will comply with Section 18115 of the CARES Act, with respect tot the reporting tot thel HHS Secretary of results oft tests intended to detect SARS-CoV-2 or to diagnose a possible case ofCOVID-19. Such reporting shall bei in accordance with guidance and direction from HHS and/or htps/www.hhs.govite.ehulvnlescovid.y-abontopy-data-reporingguinancepdr.Furtner, consistent with the full scope of applicable grant regulations (45 C.F.R. 75.322), the purpose of this award, and the underlying funding, the recipient is expected toj provide to CDC copies of and/or access to COVID-19 data collected with these funds, including but not limited to data related to COVID-191 testing. CDC will specify ini further guidance and directives what is encompassed byt this requirement.This awardi is contingent upon agreement by the recipient to comply with existing and future guidance from the HHS Secretary regarding control oft thes spread ofCOVID-19. In addition, recipient is expected toi flow down these terms to any subaward, tot the extent applicable to activities set out in such subaward.The recipient must exercise proper stewardship over Federal funds by ensuring that all çosts charged are allowable, allocable, andr reasonable  CDC. HHS laboratory reporting guidance is posted at:  Task Order! Number: 2024*0719  Page 2 of2  Version 04.1 15,2022    DocuSign Envelope ID: E34OF4GE63-AEABIF09F22F201759  EXHIBITI B  STATEMENT OF WORK To Original Contract Number 2024*0719  These provisions are tol be read and interpreted in conjunction with the provisions oft the contract specified above. This project serves to advance Colorado's public health and environmental workforce capacity through public health transformation. Public health transformation will grow, sustain, and diversify the public health workforce by strengthening the public health workforce's capacity for planning, development, management, forecasting, and quality improvement efforts. The Colorado Department of Public Health & Environment (CDPHE) will use the Centers for Disease Control and Prevention (CDC) grant funds to strengthen partnerships and build resilience among Colorado's public health workforce in 53 local public health agencies (LPHAs). Thel LPHAS shall use the funds to grow and sustain the workforce capacity. With a thriving workforce, local public health agencies will be enabled to support local communities in a larger way. The CDPHE's Office of Public Health Practice, Planning, and Local Partnerships (OPHP) will work with all LPHAS to support public health workers in the public health system, CDPHE will support LPHAS with additional resources to: address the increased labor market competition, increased workload demands, and will monitor that public health and environmental staff have the proper knowledge and training. Local Public Health Agencies shall hire staff, and implement a new employees retention  1. Project Description:  system through professional development training and cross-training.  2. Definitions:  1. Infrastructure: The CDC grant titled, "Strengthening U.S. Public Health) Infrastructure, Workforce, and  Data Systems."  3. Work Plan:  Goal #1: Advance Colorado's public health workforce capacity through public health transformation by strengthening Objective #1: No later than the expiration of the contract, support the Colorado public health workforce.  partnerships and building resilience among Colorado's public health workforce.  1. The Contractor shall create a final project budget. 1. The Contractor shall track the spend down oft the award.  Primary Activity #1 Sub Activity #1 Primary Activity #2 Primary Activity #3 Primary Activity #4 Primary Activity #5  2. The Contractor shall update Infrastructure award budgets to show the spend down 1. The Contractor shall complete a standard progress report every 3 months. 1. The Contractor shall create a fivey year workplan utilizing workforce activities in the https/www.edc.ovinfasinclure/hdmpendxelsample-activiticssoomponenta.ndr 1. The Contractor shall attend the following meetings with CDPHE:  progress,  CDC sample activities document: a) aPost-award meeting and b) annual program check inj meetings. 1. The Contractor shall create af final report.  Task Order Number: 2024*0719  Page 1 of 3Version 02.24.2022    DocuSign Envelope ID:  1. The content ofe electronic documents located on CDPHE and non-CDPHE websites and information contained on CDPHE andi non-CDPHE websites may be updated 2. CDPHE wills schedule the annual check in meetings with the Contractor within 45 days 4. The Contractor shall communicate any projected budget changes thati resulti ina a new budget linei item or are over 25% oft the total budget tot the CDPHE contract monitor that may resulti ini unobligated funds within 30 days of acknowledgment of changes. 5. The Contractor shall use the CDPHE budget template for the final project budget. 6. The Contractor shall use the CDPHE: 31 month Progress Report andl Finall Progress 7. CDPHE wille electronically provide the Contractor, within thirty (30) days from contract  periodically duringt the Contract term, of contract execution.  3. The Contractor shall comply with all funding requirements.  Report Templates. execution, the following templates: a) aCDPHE Budget Template, b) a3r month] Progress Report Template, and c) aFinal Report Template. programs to verify services provided. assistance from the Component Bi national grantees. 10. CDPHE will create at technical assistance intake form.  Standards and Requirements  8. CDPHE will compile data that has been provided by the Contractor to other CDPHE 9. Contractor shall submit technical assistance questions to CDPHE tor receive technical 11. CDPHE will provide the: required workplan template tot the Contactor within thirty (30) 12. The Contractor shall upload thei required workplan and budget via the links supplied by 13. The Contractor shall complete a final report within sixty (60) days ofa alli funds being  days from contract execution. CDPHE.  spent, and no later than] November 30,2027. 1. Increase of the public health workforce. 2. Retention oft thej public health workforce.  Expected Results of Activity(s) Measurement of Expected Results  . Number of:  a, Full" Time Equivalents (FTE)I hired, and/or b. Full Timel Equivalents (FTE)trained, and/or  Full Time) Equivalents (FTE)receiving retention efforts, and/or  d. Interns hired. electronically to OPHP OPHP.  Completion Date No later than 30 days after Contract execution. after Contract execution. Due every February 1st, May 1st, August 1st, and November Ist until final progress report. No later than 60 days after alli funds were spent, and no later than Nov. 30, 2027  1. The Contractor shall submit the final project budget  2. The Contractor shall submit the workplan electronically to Nol later than 30 days  3. The Contractor shall submit Progress Reports every 3 months electronically to OPHP until all funds are spent 4. The Contractor shall submit al Final Progress Report  Deliverables  down.  electronically to OPHP.  Task Orderl Number: 2024*0719  Page 2 of 3Version 02.,24,2022    DocuSign Envelope ID:  4. Monitoring:  CDPHE's monitoring of this contract for compliance with performance requirements will be conducted throughout the contract period by the Office of Public Health Practice, Planning, and Local Partnerships' Contract Monitor. Methods used will include a review of documentation determined by CDPHE to be reflective of performance to include progress reports, site visits, and other fiscal and programmatic documentation as applicable. The Contractor's performance will be evaluated at set intervals and communicated tot the contractor. Al Final Contractor Performance Evaluation will be conducted at the end of  thel life of the contract. 5. Resolution of Non-Compliance:  The Contractor will be notified in writing within (7) calendar days of discovery of a compliance issue. Within (30) calendar days of discovery, the Contractor and the State will collaborate, when appropriate, to determine the action(s) necessary to rectify the compliance issue and determine when the action(s) must be completed. The action(s) and timeline for completion willl be documented in writing and agreed tol by both parties. Ifextenuating circumstances arise that requires an extension to the time line, the Contractor must email a request to the Contract Monitor andi receive approval fora a new due date. The State will oversee the competio/mpememation of the action(s) to ensure timelines are met and the issue(s). is resolved. Ifthe Contractor demonstrates inaction or disregard for the agreed upon compliance resolution plan, the State  may exercise its rights under thej provisions oft this contract.  Task Order Number: 2024*0719  Page 3 of 3Version 02.24.2022    DocuSign Envelope ID:  EXHIBIT C  BUDGET  COLORADO Department of Public Health 81 Environment  I. II. BUDGET: ONE TIME PAYMENT 12/1/2022 -1 11/30/2027  ENTITY NAME: PROWERS COUNTY PUBLIC HEALTH  TOTAL PAYMENT $331,314.00 $331,314.00  TOTAL  Task Orderl Number: 2024*0719  Page 1c of1  Version 05. 02.2022    DocuSign Envelope ID:  Exhibit D  Federal Provisions - Advancing Colorado's Public Health Workforce Capacity, Data, and For the purposes oft this Exhibit only, Contractor is alsoi identified as "Subrecipient." This Contract has been funded, in whole or inj part, with an award of Federal funds. Ini the event ofa conflict between the provisions of these Supplemental Provisions for Federal Awards, the Special Provisions, the Contract or any attachments or exhibits incorporated into andi made aj part of the Contract, the Supplemental Provisions for Federal Awards shall control. Ini the event ofa conflict between the Supplemental Provisions for Federal Awards andt the FFATA Supplemental Provisions (ifa any), the FFATA Supplemental Provisions shall control.  Equity Through Public Health Transformation  1) Federal Award Identification.  a. Subrecipient: Prowers County Public Health. b. Subrecipient Unique Entity Identification Number: d. Thel Federal award datei is November 29, 2022.  SAMI Unique Entity ID (UEI): Y8C4HSXY95M6 C. Thel Federal Award Identification Number (FAIN)is NEIIOE000089.  e. The subaward period of] performance start date is. July 1, 2023 and end datei is November 30,  2027. Federal Funds: Federal Budget Period 12/01/2022  11/30/2023  Total Amount of] Federal Funds Awarded $34,783,995.00  Amount of Federal Funds Obligated to CDPHE $34,783,995.00  g. Federal award title of project or program: Advancing Colorado's Public Health Workforce Capacity, Data, and Equity Through Public Health Transformation. h. Thei name of thel Federal awarding agency is: Centers for Disease Control and Prevention and the contact information fort the awarding official is Ms. Tia Yancey, Program Officer, Center for Surveillance, Epidemiology and Laboratory Services (CSELS), tby4@cdc.gov; the name oft the pass-through entity ist the State of Colorado, Department ofF Public Health and Environment (CDPHE), and the contact information for the CDPHE official is Enter Grantee The Catalog of Federal Domestic Assistance (CFDA) number is 93.967 and the grant name is k. Subrecipient is not required toj provide matching funds. Int the event the Subrecipient is required to Thei indirect cost rate: for thel Federal award (including ifthe de minimis rate is charged per 2 CFR $200.414 Indirect (F&A) costs) is pre-determined based upon the State of Colorado and CDPHE  (CDPHE) Project Director.  CDC Collaboration with Academia to Strengthen Public Health. This award is not for research & development. provide matching funds, Section 8 oft this Attachment applies.  cost allocation plan.  Task Order Number: 2024*0719  Page 1 of4  Version 05.02.2022    DocuSign Envelope ID: E4OFSEGI3-AEABIF09F2E2P20T69  2) Subrecipient shall at allt times during the term oft this contract strictly adhere to the requirements under the Federal Award listed above, and all applicable federal laws, Executive Orders, andi implementing 3) Any additional requirements that CDPHE imposes on Subrecipient in order for CDPHE to meet its own responsibility to thel Federal awarding agency, including identification ofany required financial and 5) Subrecipient must permit CDPHE and auditors tol have access to Subrecipient's: records and financial statements as necessary for CDPHE to meet thei requirements of2 CFR $200.331 Requirements for pass-through entities, SS 200.300 Statutory and National Policy Requirements through $200.309 Period of 6) The appropriate terms and conditions concerning closeout of the subaward are listed in Section 16 ofthis 7) Performance and) Final Status. Subrecipient shall submit all: financial, performance, and other reports to CDPHE no later than 45 calendar days after the period of performance end date or sooner termination of this Contract containing an evaluation and review of Subrecipient's performance and the final status of 8) Matching Funds. Subrecipient shall provide matching funds as stated in the Exhibits. Subrecipient shall have raised the full amount ofmatching funds prior tot the Effective Date and shall report to CDPHE regarding the status ofs such funds upon request. Subrecipient's obligation toj pay all or any part ofany matching funds, whether direct or contingent, only extends toi funds duly and lawfully appropriated for the purposes oft this Contract by the authorized representatives of the Subrecipient and paidi into the Subrecipient's treasury or bank account. Subrecipient represents to CDPHE that the amount designated as matching funds has been legally appropriated for the purposes oft this Contract by its authorized representatives andj paid intoi its treasury or bank account. Subrecipient does not by this Contract irrevocably pledge present cash reserves for payments in future fiscal years, and this Contract is not intended to create ai multiple-fiscal year debt of the! Subrecipient. Subrecipient shall not] pay or be liable for any claimed interest, late charges, fees, taxes or penalties of any nature, except as required by 9) Record Retention Period. The record retention period previously stated in this Contract is replaced with 10) Single Audit Requirements. IfSubrecipient expends $750,000 or more inl Federal Awards during Subrecipient's fiscal year, Subrecipient shall procure or arrange for a single or program-specific: audit conducted for that year in accordance with the provisions of Subpart F-Audit Requirements oft the Uniform Guidance, issued pursuant to the Single Audit Act Amendments of 1996, (31 U.S.C. 7501-7507). 2CFR 11) Contract Provisions. Subrecipient shall comply with ands shall include all of thei following applicable a. Office ofl Management and Budget Circulars and' The Common Rule for Uniform Administrative Requirements for Grants and Cooperative Agreements to State andi Local Governments, as b. when: required by) Federal program legislation, the "Davis-Bacon Act", as amended (40 U.S.C. 3141-3148) as supplemented by Department ofLabor Regulations (29 CFR Part 5, "Labor Standards Provisions Applicable to Contracts Covering Federally Financed and Assisted when required by Federal program legislation, the Copeland "Anti-Kickback" Act (40U.S.C. 3145), as supplemented by Department ofLabor regulations (29 CFR Part 3, "Contractors and Subcontractors on Public Building of Public Work Finançed in Whole ori inl Part by Loans or d. 42U.S.C. 6101 et seq., 42 U.S.C. 2000d, 29 U.S.C. 794 (regarding discrimination);  regulations as they currently exist and may hereafter be amended. 4) Subrecipient's approved indirect cost rate is as stated in thel Exhibits. performance, and Subpart F-Audit Requirements oft this Part.  performance. reports, are statedi ini thel Exhibits.  Attachment.  Subrecipient's obligations hereunder.  Subrecipient's laws or policies.  the record retention period prescribed in 2CFR $200.333.  $200.501.  provisions in all subcontracts entered intol by it pursuant tot this Contract:  applicable;  Construction");  Grants from the United States").  Task Order Number; 2024*0719  Page 2 of4  Version 05.02.2022    DocuSign Envelope ID:  the Americans with Disabilities Act" (Public Law 101-336; 42 U.S.C. 12101, 12102, 12111- 12117, 12131-1 12134, 12141-1 12150, 12161-1 12165, 12181-1 12189, 12201 - 12213 and 47 when applicable, the Contractor shall comply with thej provisions of the' "Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local Governments" g. Thel Federal Funding Accountability and' Transparency Act of2 2006 (Public Law 109-282), as amended by $6062 of Public Law 110-252, including without limitation all datai reporting requirements required there under. This Act is also referred to as FFATA. h. Contractor shall comply with the provisions of Section 601 ofTitle VI of the Civil Rights Actof Except as otherwise provided under 41 CFR Part 60, all contracts that meet the definition of "federally assisted construction contract" in 41 CFR Part 60-1.3 comply with the equal opportunity clause provided under 41 CFR 60-1.4(b), in accordance with Executive Order 11246, "Equal Employment Opportunity: (301 FR 12319, 12935, 3 CFR Part, 1964-1965 Comp., p.339), as amended by Executive Order 11375, "Amending Executive Order 112461 Relating to Equal Employment Opportunity," and implementing regulations at 41 CFR part 60, "Office of] Federal Contract Compliance Programs, Equal Employment Opportunity, Department ofLabor. where applicable, Contract Work Hours and Safety Standards Act (40 U.S.C. 3701-3708). ifthel Federal award meets the definition of"funding agreement" under 37 CFR $ 401.2 (a) and ther recipient or subrecipient wishes to enteri into an agreement with as small business firm or nonprofit organization, comply with the requirements of37 CFR Part 401, "Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative Agreements," and any implementing regulations issued by the the Clean Air Act (42 U.S.C. 7401-7671q.) and the Federal Water Pollution Control Act (33 m. ifapplicable, comply with the mandatory standards and policies on energy efficiency contained within the State of Colorado's energy conservation plani issued in compliance with thel Energy n. the Contractor and all principals are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal department or agency; the Contractor and all principals shall comply with all applicable regulations pursuant tol Executive Order 12549 (3 CFR Part 1986 Comp., p. 189) and Executive Order 12689 (3 CFR the Contractor shall comply where applicable, thel Byrd Anti-Lobbying Amendment (31 U.S.C.  U.S.C. 225 and 47U.S.C.611); (Common Rule);  1964, as amended.  awarding agency. U.S.C. 1251-1387), as amended.  Policy and Conservation Act, 42 U.S.C. 6201.  Part 1989 Comp., p. 235), Debarment and Suspension; and,  1352).  12) Compliance. Subrecipient shall comply with all applicable provisions of The Office of] Management and Budget Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance), including but not limited tot these Supplemental: Provisions for Federal Awards. Any revisions tos such provisions automatically shall become a part oft these Supplemental Provisions, without thei necessity of either party executing any further instrument. CDPHE may provide written notification to Subrecipient of such revisions, but such notice shall not be a condition precedent to 13) Procurement Procedures. Subrecipient shall use its own documented procurement procedures which reflect applicable State, local, and' Tribal laws and regulations, provided that thej procurements conform to  the effectiveness ofs such revisions.  Task Order Number: 2024*0719  Page 3 of4  Version 05,02.2022    DocuSign Envelope ID: EAOFA6E6I3-AEBBFF09F2E2F201759  applicable Federal law and the standards identified in the Uniform Guidance, including without 14) Certifications. Unless prohibited by Federal statutes or regulations, CDPHE: may require Subrecipient to submit certifications and representations required by Federal statutes or regulations on an annual basis (2 CFR $200.208). Submission: may bei required more frequently if Subrecipient fails tor meet a requirement oft thel Federal award. Subrecipient shall certify in writing to CDPHE at the end of the Contract that the project or activity was completed or the level ofe effort was expended. 2 CFR $200.201(b)(3). Ifthe required. level of activity or effort was not carried out, the amount oft the Contract must be adjusted. 15) Event of Default. Failure to comply with thel Uniform Guidance or these Supplemental Provisions for Federal. Awards shall constitute an event of default under the Contract pursuant to 2CFR $200.339and CDPHE may terminate the Contract in accordance with the provisions in the Contract. 16) Close- Out. Subrecipient shall close out this Contract within 45 days after the End Date. Contract close out entails submission to CDPHE by Subrecipient of all documentation defined as a deliverable int this Contract, and Subrecipient's final reimbursement: request. Ifthe project has not been closed by the Federal awarding agency within 1 year and 45 days after thel End) Date due to Subrecipient's failure to submit required documentation that CDPHEI has requested from Subrecipient, then Subrecipient may be prohibited from applying for new. Federal awards through the State until such documentation has been 17) Erroneous Payments. The closeout of al Federal award does not affect the right oft thel Federal awarding agency or CDPHE to disallow costs andi recover funds on the basis ofal later audit or other review. Any  limitation, $$200.318 through 200.326 thereof.  submitted and accepted.  cost disallowance recovery is to be made within the record retention period.  Task Order Number: 2024*0719  Page 4 of4  Version 05.02.2022    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested: 6/13/2023 Submitter: Department of] Human Services  Submitted to the County Administration Office on: 6/2/2023 Return Originals to: Department of Human Services Number of originals to return to Submitter: 1  Contract Due Date: ASAP  Item Title/Recommended Board Action:  Consider approval of Contract Amendment #4, 23 IHFA 182250, original contract #128142 between Prowers County and the Colorado Department of Human Services to provide support of the Child Welfare Abuse and Neglect Hotline-Routine System, total amount of$ $5,162,133.85 with the expiration date of 6-30-2024 and authorizing Lanie Meyers-Mireless, Department of  Human Services Director, to execute the document electronically.  Justification or Background: County: $5,162,133.85  Fiscal Impact: Thisi item is budgeted in the following account code:  Federal: $  State: $  Other:  $  Approved by the County Attorney on: Additional Approvals (if required):    COLORADO Financial Services Daptamansase Division of Contracts and  CONTRACT AMENDMENT #4 SIGNATURE. AND COVER PAGE  State Agency Colorado Department of! Human Services Contractor Prowers County 301 South Main, Suite 215 Lamar, CO81052 Current $4,084,843.61 Initial Term Statel Fiscal Year 2020 Extension Terms Statel Fiscal Year 2021 Statel Fiscal Year 2022 Statel Fiscal Year 2023 Statel Fiscal Year 2024 Total for All State Fiscal Years  Original Contract. Number 201 IHFA 128142 Amendment Contract Number 23 IHFA 182250 Contract Performance Beginning Date July 1,2019 Current Contract Expiration. Date  $995,550.00 $1,009,388.00 June 30, 2024 $1,029,504.57 $1,050,401.04 $1,077,290.24 $5,162,133.85  THE: PARTIES HERETO HAVE EXECUTED THIS. AMENDMENT  Each person signing this Amendment represents and warrants thath he or shei is duly authorized to execute this Amendment  and tol bindt the Party authorizing his or hers signature.  CONTRACTOR Prowers County Lanie Meyers-Mireles Director Department of Social Services forl Prowers County  STATE OF COLORADO Jared] Polis, Governor Department ofH Human Services Michelle Barnes Executive Director  By: Laniel Meyers-Mireles Director) Department of Social  By: Minna Castillo-Cohen, Director, Office of Children,  Services for Prowers County  Youth and Families  Date:  Date:  Ina accordance with $24-30-202 C.R.S., this Amendment ist not valid until signed and dated below byt the! State Controller oran  authorized delegate. STATE CONTROLLER Robert. Jaros, CPA, MBA, JD Andrea Eurich/Toni Williamson/Telly Belton  By:  Amendment Effective Date:    1. PARTIES  This Amendment (the "Amendment")t to the Original Contract shown on the Signature and Cover Page for this Amendment (the' "Contract") is enteredi into by and between the Contractor, and the State. Except as specifically modified by this Amendment, all terms used in this Amendment that are defined int the Contract shall be construed and interpreted in accordance with the Contract.  2. TERMINOLOGY  3. AMENDMENT EFFECTIVE DATE AND TERM A. Amendment Effectivel Date  This Amendment shall not be valid or enforceable until the Amendment Effective Date shown on the Signature and Cover Page for this Amendment. The State shall not be bound by any provision oft this Amendment before that Amendment Effective Date, and shall have no obligation to pay Contractor for any Work performed or expense incurred under this Amendment either before or after the Amendment term shown in $3.B of this Amendment. Thel Parties' respective performances under this Amendment and the changes to the Contract contained herein shall commence on the. Amendment Effective Date shown on the Signature and Cover) Page fort this Amendment or ands shall terminate on1 thet termination oft the Contract.  B. Amendment Term  4. PURPOSE  The purpose of this Amendment is in support of the Child Welfare Abuse and Neglect Hotline Routine System. This amendment serves to extend contract services to the end of the State Fiscal Year  2024 and increase the maximum amount as shown above.  5. MODIFICATIONS  The Contract and all prior amendments thereto, if any, are modified as follows:  A. The Contract Amendment Expiration Date on the Contract's Signature and Cover Page is hereby deleted and replaced with the Current Contract Expiration Date shown on the B. The Contract Maximum Amount table on the Contract's Signature and Cover Pagei is hereby deleted and replaced with the Current Contract Maximum Amount table shown on the Exhibit B3 - Budget, isl hereby deleted in its entirety and replaced with Exhibit B4 - Budget,  Signature and Cover Page for this Amendment. Signature and Cover Page for this Amendment. attached and incorporated! herein,  6. LIMITS OF EFFECT AND ORDER OF PRECEDENCE  This Amendment is incorporated by reference into the Contract, and the Contract and all prior amendments or other modifications to the Contract, if any, remain in full force and effect except as specifically modified in this Amendment. Except for the Special Provisions contained in the Contract, in the event of any conflict, inconsistency, variance, or contradiction between the provisions of this Amendment and any oft the provisions of the Contract or any prior modification to the Contract, the provisions of this Amendment shall in all respects supersede, govern, and control. The provisions of this Amendment shall only supersede, govern, and control over the Special Provisions contained in the Contract to the extent that this Amendment specifically  modifies those Special Provisions. Amendment Contract Number: 231 IHFA 182250  Page2of2  Rev. 1/14/19    A  3 6A 6A 6 A        A    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested: June 13, 2023 Submitter: Meagan Hillman, PCPHE Director  Submitted to the County Administration Office on: 06/05/2023 Return Originals to: Meagan Hillman PCPHE Director Number oforiginals to return to Submitter: 1 Contract Due Date: Deadline 6/15/2023 Item Tite/Reommended Board Action:  Consider approval of Case Management Retention Phase 2 Grant Application for OLTC Retention Payments, ini the amount of $750 per OLTC Staff Members and authorizing Meagan  Hillman, Public Health Director to execute the document electronically.  Justification or Background: This is funding from HCPF for retention project of $750.00/Case  Manager, Case Manager Supervisor and Case Manager Assistant Fiscal Impact: This item is budgeted in the following account code:  County: $  Federal: $  State: $  Other: $  Approved by the County Attorney on: Additional Approvals (ifrequired):    6/5/23, 10:48AM  Casel Management Retention Phase 2 GrantA Application & Statement ofA Assurance Form  Case Management Retention Phase 2 Grant Application & Statement ofAssurance Form The purpose oft the retention payments being offered are to encourage Case Managers to remain employed with their current case management agency, single entry point or community centered  board throughout their companies' transition phases.  ! Indicates required. question  1. Email *  2. Legal Business Name: *  3. Authorized Representatives Name and Title: *  4. Phone number *  5. FULL: Business Address: *  htps-ldocagoagle.com.ionurxuemoAl4p2CATOAMANPwDehox2aHalkleat  1/5    6/5/23, 10:48AM  Casel Management Retention! Phase 2 GrantA Application & Statement ofAssurance Form  6. The applicant organization listed above hereby accepts the conditions oft the Case Management Retention grant program and agrees to the following assurances:  Check all that apply.  The retention grant funds requested in the application will be administered in accordance with all applicable statutes, regulations, program plans, and requirements delineated in this application. The applicant meets all eligibility requirements of the grant as outlined int the Case Manager The Applicant understands iti is their responsibility to make thei initial payments to each qualified The Applicant understands the 100% of the Gross retention grant funds will go directly to each qualified staff and any outstanding taxes, fees, and/or administrative expenses ensued are the  Retention Payments Memo  staff and submit invoices for reimbursement.  responsibility of the applicant organization to cover.  The applicant willj provide documentation that each staff receiving the retention bonus meets the eligibility criteria using Department requested form or one with the same: information of the agency's Each eligible staff must have completed required training and be in good standing with agency Applicant must have an approved Grant Appication/Atestation form with thel Department to be Applicant understands that the: funds requested in this application are likely the maximum amount that can be paid, the department may not have additional funds available for costs invoiced Applicant agrees to develop a procedure for retention of Case) Management staff through the IFA ANY FINDINGS OF MISUSE OF FUNDS AREI DISCOVERED, RETENTION FUNDS MUST BEI RETURNED TOTHE COLORADO DEPARTMENT OF HEALTH CARE POLICY ANDI FINANCING (the Department). The Department may terminate a grant award upon thirty (30) days' notice ifiti is deemed by the Department that the recipient is not fulfilling the requirements of The applicant will cooperate with any examination of records with respect to such Colorado Department of Healthcare Policy and Financing (thel Department), the Office of eHealth Innovation (OeHI), the State of Colorado, or any auditors on its behalf; or (ii) any other state agency, commission, or department in the lawful exercise ofi its jurisdiction and authority. All information contained in this application is true and accurate.  choosing..  performance standards. eligible fori reimbursement.  above the requested amount.  Case Management Redesign contract transition.  thei funded program as specified.  mtps.ldocsgoogle.com.toasenurR.emFopZaMalwleain  2/5    6/5/23, 10:48AM  Case Management Retention Phase 2 Grant/ Application & Statement ofA Assurance Form  7. Please provide al brief description of non monetary incentives this agency is providing it's  stafft to align with the purpose ofthis grant?  8. Agencies will be eligible for up to $7501 for each eligible staff. How much are you asking per Case Manager Supervising staff?  Ifac different amount (less than $750), per. staff please mark other"with the amount you are  requesting. Mark only one oval.  Full amount of $750 per eligible staff..  Other:  9. Agencies will be eligible for up to $750 for each eligible staff. How much are you asking per Case Managerstaff?  Ifadifferent amount (less than $750), per staffplease mark "other"with the amount you are  requesting. Mark only one oval.  Full amount of $750 per eligible staff.  Other:  ps/ldocsgpole.com.iomhomasanurguenRo.aigp2DMITOAMANPoxZahzlwledit  3/5    6/5/23, 10:48A AM  Case Management Retention Phase 2 GrantA Application & Statement ofA Assurance Form  10. Agencies will be eligible for up to $750 for each eligible staff. How much are you asking per Case. Aide: staff?  Ifa diffèrent amount (less than $750). per staff please mark "other"with the amount you  are requesting. Mark only one oval.  Full amount of $750 per eligible staff.  Other:  11. How many Case Management Supervisor staffa are you requesting the above dollar amount *  for payment?  12. How many Case Management staff are you requesting the above dollar amount for  payment?  13. How many Case Management. Aide staff are you requesting the above dollar amount for *  payment?  14. By adding your name on this Statement ofA Assurançes document, the applicant attests that * all information indicated in this document is accurate and true. The applicant signature must be the same as the authorized representative. The applicant agrees and acknowledges that by printing their name here it acts as their signature in order for the application to be  valid.  mtpsldocagoogle.comionurkuemRoAL4P2OA/O2MANOwDehoxZaHzlwleait  4/5    6/5/23, 10:48AM  Case! Management Retention Phase 2 GrantA Application & Statement ofA Assurance Form  This content is neither created nor endorsed by Google.  Google Forms  tps-ldocagogle.com.iomomsenurR.enRo.aMFDAl4D2DATOAMANPwDehox2aMzlkledn  5/5    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested: 6-13-2023 Submitter: Department of Human Services  Submitted to the County Administration Office on: 6/5/23 Return Originals to: Department of Human Services Number of originals to return to Submitter: 1  Contract Due Date: ASAP  Item Ttle/Recommended Board Action:  Consider approval of Contract Amendment #2, 21 IHGA 184263 original Contract # 21 IHGA 168850 between Colorado Department of Human Services and Prowers County Department of Human Services for use of The Work Number from June 1, 2022 through June 30, 2024, total amount $59,360.63 for all State Fiscal Years and authorizing Lanie Meyers-Mireles to execute the  document electronically. Justification or Background:  Fiscal Impact: This item is budgeted in the following account code:  County: $_ Federal: State: Other:  $_ $_ $_    DocuSign Envelope ID: BFOSAF8078154EEDBASEF/3EF354680  COLORADO Financial Services Departmento otHumans Services Division of Contracts andP Procurement  CONTRACT AMENDMENT #2 SIGNATURE AND COVER PAGE  State Agency Colorado Department of Human Services Office of Economic Security Division of Economic and Workforce Support Contractor Prowers County Contractor's State of Incorporation: Colorado Current Contract Maximum. Amount Initial Term 06012021-05312022 Extension' Terms 06.012022-0531/2023 06/012025-06302024" Total for All State Fiscal Years *Any amount paid as a result ofl Holdover. Letter 24 IHGA_ 184036 prior to execution ofthis Contract shall be deducted from the Contract Maximum Amount.  Original Contract Number 211 IHGA 168850 Amendment Contract Number 241 IHGA 184263 Contract Performance Beginning Date June 01, 2022 $101.79 Current Contract Expiration Date $154.09 June 30, 2024 $59,104.75 $59,360.63  THE PARTIES HERETO HAVE: EXECUTED: THIS AMENDMENT  Each person signing this Amendment represents and warrants that he ors she is duly authorized to execute this Amendment  and tol bind the Party authorizing his orl her signature.  CONTRACTOR Prowers County  STATE OF COLORADO Jared Polis, Governor Colorado! Department of Human Services Michelle Barnes, Executive: Director By: Barry. J. Pardus, Deputy Director, Office of Economic Security  By: Lanie Meyers-Mireles  Date:  Date:  Ina accordance with $24-30-202 C.R.S., this Amendment is not valid until signed and dated below byt the State Controller or an  authorized delegate. STATE CONTROLLER Robert. Jaros, CPA, MBA,JD Andreal Eurich/Toni Williamson/Telly Belton  By:  Amendment Effective Date:    DocuSign Envelope ID: BFOSAFB07A154ED.BASEF/3EF3S464D  1. PARTIES  This Amendment (the "Amendment") to the Original Contract shown on the Signature and Cover Page for this Amendment (the "Contract") is entered into by and between the Contractor, and the State. Except as specifically modified by this Amendment, all terms used in this Amendment that are defined ini the Contract shall be construed and interpreted in accordance with the Contract.  2. TERMINOLOGY  3. AMENDMENT EFFECTIVE DATE AND' TERM A. Amendment Effective Date  This Amendment shall not be valid or enforceable until the Amendment Effective Date shown on the Signature and Cover Page for this Amendment. The State shall not be bound by any provision oft this Amendment before that Amendment Effective Date, and shall have no obligation to pay Contractor for any Work performed or expense incurred under this Amendment either before or after the Amendment term shown in $3.B oft this Amendment. Thel Parties' respective performances under this Amendment and the changes to the Contract contained herein shall commence on the Amendment Effective Date shown on the Signature and Cover Page for this Amendment or. June 01, 2023, whichever is later and shall terminate  B. Amendment Term  on the termination of1 the Contract,  4. PURPOSE  The State entered into a Contract with the TALX Corporation, a provider of Equifax Verification Services ("EVS"), for use of The Work Number. The State and the County entered into a Contract that allows the County to participate with the State acting as aj pass-through entity tol benefit from bulk] pricing oni income verification from The Work Number. This Amendment adds an additional term and modifies  the Contract Maximums Amount, 5. MODIFICATIONS  The Contract and all prior amendments thereto, ifa any, are: modified as follows:  A. The Contract Initial Contract Expiration Date on the Contract's! Signature and Cover Page isl hereby deleted and replaced with the Current Contract Expiration Date shown on the B. The Contract Maximum. Amount table on the Contract's Signature and Cover Page is hereby deleted and replaced with the Current Contract Maximum Amount table shown on C. Exhibit A-1- Statement of Work is modified by the addition of Exhibit A-2- - Statement D. Exhibit C-1 - Amendment 11 - 22 IHGA 175559: is modified by the addition ofl Exhibit C-2-Amendment 14- 23 IHGA 184226, attached and incorporated herein.  Signature and Cover Page fort this Amendment. the Signature and Cover Page for this Amendment. ofWork, attached and incorporated herein. LIMITS OF EFFECT AND ORDER OFI PRECEDENCE  This Amendment is incorporated by reference into the Contract, and the Contract and all prior amendments or other modifications to the Contract, if any, remain in full force and effect except as specifically modified in this Amendment. Except for the Special Provisions contained in the Contract, in the event of any conflict, inconsistency, variance, or contradiction between the  Amendment Contract Number:2  Page2of3  Rev. 1/14/19    DocuSign Envelopel ID: FOSAFBD7a154EEDBASEF/3EF3A6AD  provisions oft this Amendment and any oft thej provisions oft the Contract or any prior modification to the Contract, the provisions of this Amendment shall in all respects supersede, govern, and control. The provisions oft this Amendment shall only supersede, gover, and control over the Special Provisions contained in the Contract to the extent that this Amendment specifically  modifies those Special Provisions.  Amendment Contract Number:2  Page 3 of3  Rev. 1/14/19    DocuSign Envelope ID: FOSAFB078154EEDBASEF/3EF3SABAD ExhibitA-2- Statement of Work  A. Background  For purposes oft this Exhibit. A, Contractor may also be referred to as' "County." The State has entered into a contract (Exhibit B - Universal Membership Agreement- 161 IHEA 83111)with" TALX Corporation, aj provider of Equifax Verification Services ("EVS") and intends to execute an amendment (Exhibit C-2- - Amendment 14- 23 IHGA 184226) to the Universal Membership Agreement (collectively "Work Number Agreement"). The Work Number Agreement allows EVS toj provide employment verification. services directly to Colorado counties. The State acts only as aj pass-through entity, meaning that EVS willl bill the! State for feesi incurred by the The Work Number Agreement is between the State and EVS with participating counties each signing Participation Agreements (seel Exhibit 1 to Universal Membership Agreement). The Work Number Agreement obligates the counties collectively and Contractor individually toj pay EVS viai the State for services rendered so the State and County are entering into this Contract to memorialize the State's and County's responsibilities as  counties, and the State will then bill the counties individually.  they relate to the Work Number Agreement,  B. Payment  County shall pay the State for County's use of services within thes scope of the Work Number Agreement. The State shall promptly pass through County's payments tol EVS in accordance with the Work Number. Agreement. Except withini its role as aj pass through entity, the State ist not liable for County's obligations incurred under this Contract or the Work Number Agreement, The State shall provide each County an invoice atl least 30 days prior to the date the payment is dué tol EVS. The State shall ensure that any payment to the Statei is paid over to EVS  prior to the date that payment is due tol EVS. C.A Annual Minimum  The Work Number Agreement byt thet terms oft the Schedule. A obligates each Participating County, through the State as the pass-through entity, toj pay the Participating County's proportionate share oft the Annual Minimum Payment as set forth in this Contract and] Exhibit 1 tot the Schedule. A. The. Minimum Payment for the period of July 1,2023 to. June 30, 2024 is $8,015,000.00, whichi is based upon an estimated 925,000income verification requests at $8.60 peri income verification request, plus a $5,000 peri month service fee. County'sresponsibility for its share ofany deficiency survives termination oft this Contract or the Work Number Agreement. County is responsible fori its percentage of the Annual Minimum Payment based upon the following formula: [County's Minimum Usagel /[Total Participating counties' Previous Usagel = County Percentage [County Percentage! X Annual Minimum Payment) +[ [Admin Feel= County Financial Obligation IFC County's Actual Annual Payment is less than County's Financial Obligation, THEN County is considereda  Deficient County and shall pay any deficiency according to the following formula:  [Annual Minimum Payment] - [Total Actual Annual Payment] = Total Deficiency [County Financial Obligation) - [County Actual Annual Payment] = County Deficiency [County Deficiencyl. /I [Total counties' Deficieneyl = Deficient County Percentage |Deficient County Percentagel XI [Total Deficiencyl = Deficient County Payment to State  Pagelof3    DocuSign Envelopel ID: BFOSAFB078154E0B4SEF73EF35468D0  This table represents each county's financial obligation:  lune1 1,2 30, 2023 Minimum Numberc of HoldOver Budget Annuals Subscription 5 25,961.19 5 37.68 $ 50,179.51 $ 36,02 $ 12.75 $ 11,856,46 $ 2,224.99 $ 12.75 $ 54.31 $ 107.51 $ 450.54 $ 61,327.19 $ 1,185.37 $ 841.78 S 29,586.57 12.75 1,837.07 116.93 106.95 26,933.20 12.75 1,085.73 123.03 19,578.26 199.50 3,756.16 203.38 1,371.57 2.549.73 12.75 45.44 12.75 9.081.18 272.65 99.75 266.00 30,774.15 226.10 119,146.49 401,699.90  July1,2023. June3 30,2 2024 Minimum Annual Account Service! Payment 68,312 $587,483.20 $4,407.20 3,596 $30,925.50 $232.00 83,562 $718,633,20 $7,004.00 31 $266.60 434 $3,732,40 26,784 $230,342.40 $1,728,00 6,882 $59,185.20 $444.00 124 $1,065.40 167 $1,436:20 620 $5,332.00 1,860 $15,996.00 $120.00 138,074 $1,187,436,40 $8,908.00 2,976 $25,593.60 $192.00 2,356 $20,261.60 $152.00 57,226 $492,143.60 $3,692.00 372 $3,199.20 6,634 $57,052.40 $428.00 558 $4,798.80 471 $4,050.50 620 $5,332,00 248 $2,132.80 45,632 $392,435.20 $2,944.00 279 $2,399.40 2,976 $25,593.60 $192.00 620 $5,332.00 31,186 $268,199.60 $2,012.00 1,922 $15,529.20 $124.00 8,680 $74,648.00 $560.00 930 $7,998.00 8,370 $71,982.00 $540.00 4,526 $38,923.60 $292.00 248 $2,132.80 620 $5,332.00 6,820 $58,652.00 $440.00 29.760 $255,936.00 $1,920.00 2,790 $23,994.00 $180.00 62 $533.20 614 $5,280.40 620 $5,332.00 62 $533:20 45,446 $390,835.60 $2.932.00 930 $7,998.00 $60.00 330,D00 $2,838,000.00 $20.000.00L 925,000 $7,955,000.00 $60,000.00  Participating Countyor Participating Entity Adams Alamosa Arapahae Archuleta Bent Boulder Broamfleid dearCreek Conelos Crowley Delta Denver Douelas Eagle EIF Paso Elbert Fremont Garfield Grand/ /lackson > Gunnison Huerfano lefferson kitCarson la Piata /SanJ Juan 5 lake larimer lasA Animas Mesa Moffat Montezuma Morgan Park Pitkin Prowers Puebla Routt San Miguel /Ouray Summit Teller Washington Weld CDHS SNAPQA HCPF Total  Transactions Includedwith Subseription Fes  TotalF Financlald Obligation  TOTAL CONTRACT AMOUNT $617,85159 $31,195.28 $775,816.71 $304.62 $3,773,15 $243,926.86 $61,854.19 $1,087.15 $1,501.31 $5,479.51 $16,566.54 $1,257,671.59 $26,970.97 $21,255.38 $525,422.17 $3,235.95 $59,317.47 $4,834.80 $4,197.93 $5,478.95 $2,14880 $422,312.40 $2,430.15 $26,872.33 $5,495.03 $289,789.86 $16,852.70 $78,954.16 $8,261.38 $73,893.57 $41,765.33 $2,161.55 $5,417.44 $59,104.75 $266,937.1B $24,446.65 $636.95 $5,585.00 $5,372.00 $537.20 $424,541.75 $B,2B4.10 $2.977.146.49 $8,416,699.90  $591,890.40 $31,157.60 $725,637.20 $268.60 $3,760.40 $232,070.40 $59,629.20 $1,074.40 $1,447.00 $5,372.00 $16,115.00 $1,196,344.40 $25,785.50 $20,413.60 $495,835.60 $3,223.20 $57,480.40 54,834.80 $4,081.00 $5,372.00 $2,148.80 $395,379.20 $2,417.40 $25,785.60 $5,372.00 $270,211.60 $16,653.20 $75,208.00 $6,058.00 $72.522.00 $39,215.60 $2,148.80 $5,372.00 $59.092.00 $257,856.00 $24,174.00 $537.20 $5,320.00 $5,372.00 $537.20 $393,767.60 $8,058.00 $2,858,000.00 $8,015.000.00  $2.00 528.00 $8.00 $10.80 $40.00  $24.00 $36.00 $30.40 $40.00 $16.00 $18.00 $40.00 $60.00 $16.00 $40.00 $4.00 $39.60 $40.00 $4.00  $ $ $  D. Miscellaneous Provisions  .  State is acting as ai fiscal agent for County, passing through payment of all costs from County to EVS, including the Annual Minimum Payment. The State shall notl be liable for any debt or payment obligation, including the Annual Minimum Payment, incurred' by County pursuant to this Contract or the Work Number. Agreement, provided, however, that any failure by the State toj pass through such payments from County shall constitute al breach ofthis Contract by the State. The State shall be obligated toj pay over tol EVS any funds received from a County. Upon breach oft this agreement byt the State, the County shall have the right to terminate this Contract upon written notice and at least thirty (30)  Page2of3    DocuSign Envelope ID: BFOSAF8078154ED.B4EF73EF35468D  days in which the State may cure the breach or any other remedy allowed byl law. IfCounty fails toj pay the State for County's costs incurred under this Contract or the Work Number Agreement, the State shall have ther right to terminate this Contract upon written notice and atl least thirty (30) daysi in which County 2. The Work Number. Agreement is for the benefit of County. Any amendments or changes to the Work Number Agreement or any new Schedule. A or amendments to Schedule. A mustl be signed by or approved by a person authorized by the governing body for each County in accordance with the County's local procedures prior to the amendment or change being effective as to aj participating county. The State shall not execute amendments or revisions to the Work Number Agreement or Schedule. A that bind any participating county without the participating counties' consent as providedl herein. 3. County'sl liability for any unpaid fees owed under this Contract or the Work Number. Agreement shall survive termination ofthis Contract as to County who has not] paid all required fees until the State 4. Annual Termination: Unless specified elsewhere ini this Contract or the Work Number Agreement, the State or County may only terminate this Contract, upon 60 days written notice, so as to align with the end of an annual term stated in the Work Number. Agreement. Ifa County elects to1 terminate its shall notl be obligated to expend any funds, including any annual minimum payment, for the years following its 5. The State may execute similar agreements with new counties not originally part oft this Contract or the Workl Number Agreement. Ift the State executes as similar agreement with a new county or counties, the State and County will recalculate the annual minimum for thes subsequent annual term. a. Extend until. June 30, 2024 the State's agreement with TALX corporation; and b. Amend, in accordance with this Contract, the State's contract with TALX Corporation.  may cure the breach.  receives payment from County.  termination.  6. County hereby grants the State authority to doi the following:  Page 3of3    DocuSign Envelope ID: BF0SAFB078154EEVBASEF/3EF3A6AD  DAIUIL L-L  AMENDMENT 14TO: THE UNIVERSAL MEMBERSHIP AGREEMENT  This Amendment 14 is entered into by and between Equifax Workforce Solutions LLC, a provider of Equifax Verification Services ("EWS" or* "EVS") and' The State of Colorado, Colorado Department of Human Services ("CDHS" or "Agency")jointly "the Parties," with reference to the following: WHEREAS, thel Parties entered into that certain Universal Membership Agreement, last signedb by WHEREAS, the Parties made effective the Schedule A - The Work Number Express Social WHEREAS, the CDHS exercised its first optional annual renewal term (as permitted in Section II of Schedule A, by means of that certain Successive Term 1 Schedule A made effective by the parties on WHEREAS, the Parties amended the Successive Term Schedule A to provide verification of employment and income services for 2 (two) additional months, beginning January 1, 2018 through February 28, 2018 (the Temporary Extension Period") while the State worked to get approval from the WHEREAS, CDHS exercised its second optional renewal term (as permitted in Section II oft the Successive Term Schedule A, by means oft that certain Amendment 1 to Schedule. A made effective by the parties on February 28,2018, for the term beginning March 1,2018 and ending on February 28, 2019 WHEREAS, the Parties subsequently: amended the Successive Term Schedule A, by means of that certain Amendment: 2 to Schedule A made effective by the parties on April 15, 2019, toj provide verification of employment and income services for 3 (three) additional months, March 1,2019t through May 31,2019 (the' "Second Temporary Extension Period; Amendment 2") while the State worked to geta approval from thep participating counties to authorize the successive term; and WHEREAS, thel Parties subsequently amended the Successive Term Schedule. A, by means of that certain Amendment 3 to Schedule. A made effective by the parties on. June 6, 2019, to provide verification of employment and income services for 3 (three) additional months, beginning June 1, 2019 through August 31, 2019 (the "Third' Temporary Extension Period; Amendment 3") while the State continued to evaluate the new pay date enhancement in order to determine the number oft transactions WHEREAS, thel Parties subsequently amended the Successive Term Schedule. A, by means of that certain Amendment 41 to Schedule. A made effectivel by the parties on August 18, 2019, to provide verification of employment and income services for 2 (two) additional months, beginning September 1, 2019 through October 31, 2019 (the "Fourth Temporary Extension Period; Amendment 4") while the State continued to evaluate the new pay date enhancement in order to determine the number of  the parties on or about August 26, 2015 (the "Agreement"); and Service on October 19,2016 (the "Schedule. A"); and December 28, 2016 (the "Successive Term Schedule A"); and participating counties to authorize the successive term; and  ("Amendment 1"); and  needed for the new contract; and  transactions needed for the new contract; and  WHEREAS, thel Parties subsequently amended the Successive Term Schedule. A, by means of that certain Amendment 51 to Schedule A made effective byt the parties on October 31, 2019, to () provide verification of employment and income services for 1 (one) additional year, beginning November 1,2019 through October 31, 2020, (2) add a Scope of Work, and (3) amend the Service Description Overview WHEREAS, thel Parties subsequently amended the Successive Term Schedule A, by means of that certain Amendment 6t to Schedule. A made effective by the parties on October 28, 2020, in order to provide the verification of employment andi income services for 1 (one) additional month, from November 1, 2020 through November 30, 2020 (the "Fifth' Temporary Extension Period; Amendment  ("Amendment 5); and  6"); and CUS-23-37455 SIGNATURE! READY  Amendment #14 tot thel Universal Membership Agreement State ofColorado- Department ofH Human Services-  Pagel 1of3 LRDMay 23,2023    Docusign Envelope ID: FOSAFB078154EEDBAASEF/3EF346D  WHEREAS, thel Parties subsequently amended the Successive Term Schedule A, by means of that certain Amendment 7 to Schedule. A made effective by the parties on) November 30, 2020, in order to provide the verification of employment andi income services for 4 (four) additional months from December 1, 2020 through March 31,2021 (the" "Sixth' Temporary Extension Period; Amendment 7); WHEREAS, thel Parties subsequently amended the Successive Term Schedule. A, by means of that certain Amendment 81 to Schedule. AI made effective by the parties on! March 25, 2021, in order to provide the verification of employment and income services for 2 (two): additional months from. Aprill, 2021 - May 31, 2021 (the "Seventh' Temporary Extension Period; Amendment 8"); and WHEREAS, the Parties subsequently amended the Agreement and the Successive Term Schedule. A, by means of that certain Amendment 91 to thel Universal Membership Agreement. and Schedule AI made effective by the parties on May 28, 2021, in order toj provide the verification of employment andi income services for 1 (one) additional year from June 1,2021 - May 31, 2022 and adda a new Scope of Work to allow Colorado government entities, Participating Entities", in addition to their existing Participating Counties, to use the Services pursuant to the terms oft the Agreement (the "Third WHEREAS, thel Parties subsequently amended the Agreement and the Successive Term Schedule A, by means of that certain Amendment 101 to the Universal Membership Agreement and Schedule A made effective by the parties on June 8, 2021, in order to add a new Section to the Scope of Work to Schedule. A forl Participating Entities only regarding Web Services and to allow HCPF al Pilot WHEREAS, the Parties subsequently amended the Agreement, by means of that certain Amendment 11 tot the Universal Membership Agreement made effectivel by thej parties on May 31, 2022, in order toj provide the verification of employment andi income services for 1 (one) additional year from June 1, 2022- - May 31, 2023 and to add access to the system by Batch (the "Fourth Successive Schedule WHEREAS, thel Parties subsequently amended the Agreement and the Successive Term Schedule A, by means oft that certain Amendment 12 to the Universal Membership Agreement made effective by the parties on October 17, 2022, in order to revise the Scope of Work to Schedule A for Employment and] Income Verification (VOE/VOI). Database and' Web Services and to reflect EWS' name WHEREAS, the Parties subsequently amended the Agreement and the Successive Term Schedule Ai inc ordert toj provide the verification of employment andi income services for one (1)additional: month from June 1,2023- -June 30, 2023 (the "Eighth Temporary Extension Period","Amendment 13"); and WHEREAS, the Parties desire to amend the Agreement and the Successive Term Schedule Ai in order toj provide the verification of employment and income services for I (one) additional year from. July 1,2 2023 - June 30, 2024; update and add pricing information; provide for Instant Client Insights web- platform in addition to batch and integration channels for Service access; ability to utilize Date Range Enhancement for The Work Number access; and add additional Services to the Agreement. All other terms and conditions of the Agreement, as previously amended, remain unchanged and in full force and effect, including the SOW tol be carriedi forward asi ifattached to this Schedule A and Amendment 14. For purpose ofthis Amendment 14, all capitalized terms used herein and otherwise defined shall have thei meaning set NOW, THEREFORE, upon Colorado State Controller signature, and effective on July 1,2023,  and  Successive Schedule A; Amendment 9"); and  Period ("Amendment 10"); and  A; "Amendment 11"); and  change ("Amendment 12"); and  forth in the. Agreement.  thel Parties do hereby agree to amend the. Agreement as follows:  CUS-23-37455 SIGNATURE READY  Amendment #14t to the Universal Membership Agreement State ofColorado- Department ofHuman Services-  Page2of3 LRDMay23,2023    DocuSign Envelope ID: BFOSAFB078154EEDB4SEF/3EF354680  This. Amendment 14 may be executed in multiple, identical, original counterparts, each of which shall be deemed to be an original, but all of which, taken together, shall constitute one andt the same document. A. CDHS hereby exercises a one (1), year extension beginning. July 1, 2023 and ending on. June 30, 2024. B. Schedule A, as has been amended from time to time, shalll be deleted ini its entirety and replaced ini full with the attached and revised Schedule A with its Schedules, Exhibits, Appendices, and Attachments, attached hereto as Schedule A. The Schedule. A replacement shall be effective as of. July 1, 2023. The SOW and Exhibit I-A to the Universal Membership Agreement fort the Participation Agreement for Participating Entity" from Amendment 9 dated May 28, 2021, shall explicitly continue to be attached IN WITNESS WHEREOF, the Parties have executed this 14TH Amendment through their duly  tot the Agreement andt the Schedule A to be effective as of. July1,2023.  authorized representatives.  STATE OF COLORADO Jared Polis, GOVERNOR Colorado Department ofl Human Services Michelle Bares, Executive Director  Equifax Workforce Solutions LLC, provider of Equifax Verification Services  By (signature): Name (print): Title: Date:  By (signature): Name (print): Title: Date:  This Amendment 14i is not valid until signed and dated below by the Colorado Department of  Human Services' Controller or Deputy Controller  COLORADODEPARTMENT OF HUMAN SERVICES  CONTROLLER  By (signature): Name/Title: (print): Date: CUS-23-37455 SIGNATURE: READY  Amendment: #141 to thel Universall Membership. Agreement State ofColorado- Department ofE Human Services-  Page3of3 LRDMay2 23,2023    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested: 6-13-2023 Submitter: Jana Coen, Sec BOCC  Submitted to the County Administration Office on: 6-6-2023 Return Originals to: Jana Coen & Paula Gonzales Number of originals to return to Submitter: 1  Contract Due Date:  Item ntle/Recommended Board Action:  Consider approval to Amend the 2023 Order for Authorized Persons and Authorized Signature on Checking Account document to remove Tamara Nickelson as an authorized agent and to add Paula Gonzales as a new  authorized agent effective June 1, 2023.  Justification or Background: Annual BOCC approval  Fiscal Impact: This item is budgeted in the following account code:  County: $_ Federal: $ State: Other:  $_ $  Approved by the County Attorney on:    ORDER FOR AUTHORIZED PERSONS AND AUTHORIZED SIGNATURES ON CHECKING ACCOUNTS (Amended)  PLORAD  The Board of County Commissioners hereby authorizes as follows regarding the  following County checking accounts at Frontier Bank:  DEPARTMENT OF HUMAN SERVICES ACCOUNT  Wendy Buxton-Andrade, Ron Cook, Thomas Grasmick, and Jana Coen are authorized to sign on the Prowers County Department of Human Services Account to transact business in this account on behalf of the Wendy Buxton-Andrade, Ron Cook, Thomas Grasmick, Jana Coen, Mark' Westhoff, Paula Gonzales, and Mindy Maestas are authorized to communicate with Frontier Bank representatives regarding the Prowers County Department of Human Services Account to transact business in this account on behalf of the Depositor. Wendy Buxton-Andrade, Ron Cook, Thomas Grasmick, and. Jana Coen are authorized to sign on the Prowers County State Wage Withholding Account to transact business in this account on behalf oft the Depositor. Wendy Buxton-Andrade, Ron Cook, Thomas Grasmick, Jana Coen, Mark Westhoff, and Paula Gonzales are authorized to communicate with Frontier Bank representatives regarding the Prowers County State Wage  Depositor.  STATE WAGE WITHHOLDING ACCOUNT  Withholding Account to transact business in this account on behalf of the Depositor.  GENERAL FUND ACCOUNT  Wendy Buxton-Andrade, Ron Cook, Thomas Grasmick, and. Jana Coen, are authorized to sign on the Prowers County General Fund Account to transact business in this account on behalf of the Depositor. Wendy Buxton-Andrade, Ron Cook, Thomas Grasmick, Jana Coen, Mark Westhoff, and Paula Gonzales are authorized to communicate with Frontier Bank representatives regarding the Prowers County General Fund  Account to transact business in this account on behalf of the Depositor.  DATED this 13th day of. June, 2023  Chairman Vice-Chairman Commissioner  IN WITNESS WHEREOF, lhave hereunto set my hand and affixed the seal of said County at Lamar, Colorado  this 13th day of June 2023.  Jana Coen, County Clerk & Recorder    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested: 6-13-2023 Submitter: Sam Zordel, County Sheriff  Submitted to the County Administration Office on: 6-6-2023  Return Originals to: Paula Gonzales  Number of originals to return to Submitter: 1  Contract Due Date:  Item ntle/Recommended Board Action:  Credit Card Authorization Request for the following: Bret Olinger, Nelson Marks, Racheal Ariatti, Ricardo Juarez, and Troy Spears for Prowers County Sheriff's Department, credit limit amount of $1,000.00 each.  Justification or Background:  Fiscal Impact: This item is budgeted in the following account code:  County: $_ Federal: $_ State: Other:  $ $_  Approved by the County Attorney on:    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested: 6-13-2023 Submitter: Sheryl Reifschneider, AP Director  Submitted to the County Administration Office on: 6-6-2023 Return Originals to: Sheryl Reifschneider, AP Director Number of originals to return to Submitter: 1  Contract Due Date:  Item Ttle/Recommended Board Action:  Credit Card Authorization Request for Paula Gonzales, Finance Director, credit  limit of $3,000.00.  Justification or Background:  Fiscal Impact: This item is budgeted in the following account code:  County: Federal: State: Other:  $_ $_ $_ $  Approved by the County Attorney on:    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested: 06/13/2023 Submitter: Mark Westhoff  Submitted to the County Administration Office on: 06/06/2023  Return Originals to: Mark Westhoff Number of originals to return to Submitter: 1  Contract Due Date: N/A  Item Tite/Reommended Board Action: Consider approving Colorado Department ofl Public Health and Environment Brownfields Assessment Grant Application to update Phase 1 and Phase 2] Brownfields Site Assessments at 207 E Elm Street, Lamar, Colorado, and authorizing County  Administrator Mark Westhoffto submit the application form online.  Justification or Background:  Fiscal Impact: This item is budgeted in the following account code:  County: $  Federal: $  State: $  Other: $  Approved by the County Attorney on: N/A Additional Approvals (if required):    STATE OF COLORADO  Bill Owens, Governor Douglas H.E Benevento, Executive Director 4300 Cherry Creek Dr. S. Denver, Colorado 80246-1530 81001 Lowry Blvd, Phone (303)6 692-2000 TDDI Line (303) 691-7700 Located in Glendale, Colorado tp/hw.dplesiaecous  Dedicated top protecting andi improving! thel health ande environment of thep people of Colorado  Laboratory Services Division Denver, Colorado 80230-6928 (303) 692-3090  Coloradol Department ofPublicHealth and] Environment  APPLICATION GUIDELINES FOR STATE OF COLORADOTARGETED BROWNFIELDS ASSESSMENT OR VOLUNTARY CLEANUP ASSISTANCE  The State ofColorado Department of] Public Health and Environment (CDPHE) is currently providing Phase 1, Phase 2, or other specific site assessment assistance at selected brownfields and voluntary cleanup properties. To request CDPHE's assistance for site assessments, interested parties must complete an application, which includes the information identified below. Applicants willl be contacted after CDPHE reviews the application. All questions may be directed to Mark Rudolph at (303)692-3311.  The site assessment application should include the following:  1. Contact Person Provide: name Telephone number Fax Number Postal address E-mail address 2. Site/Project location  Provide the site name and address, including city, county, zip code and total acreage. Ifavailable, provide ai map ofthe site (preferably its latitudinal and longitudinal location on a  USGS topographical quadrangle map). Provide amount of delinquent property taxes (ifa any). Provide assessed value oft thej property.  3. Site History and Current Status  Briefly describe the known past and current uses of the site.  Describe local/state/federal regulatory involvement at the site (e.g. whether CDPHE or EPA has already invested funds in the property or if there is an ongoing or planned state/federal enforcement action at the site). Information should include whether or not there has ever been a Describe environmental conditions, including level and type ofcontamination (ifl known) and a summary ofany known past environmental investigations. Summarize past and present Describe past, current, and future ownership status. If property is not owned by applicant, describe how applicant anticipates obtaining access to property in order to conduct assessment  response action taken at the site either under CERCLA or RCRA.  developer interest. activities.    4.Project Period and Budget  State the desired project completion time period and schedule.  Provide al budget page showing al breakdown of assessment activities and estimated costs. Describe how the site ownership will be controlled (i.e., publicly owned either directly by ai municipality or through a quasi-public entity, such as a community development corporation). Privately owned sites need to provide a substantial public benefit or a clear means ofhow CDPHE expenditures will be recouped either through an agreement or lien. Describe the roles of all other key stakeholders in the project (i.e., community Describe efforts directed towards community involvement (i.e., is the community aware ofthe project, and do they support the proposed redevelopment?). Ifcommunity is not Identify cleanup-funding sources (i.e., direct or leveraging off funds and availability of Describe redevelopment plans (i.e. the desired future use oft the site, the likelihood of redevelopment, and how the site fits within overall redevelopment plans). List any commitments inj place that provide evidence that this brownfields or voluntary cleanup site will be cleaned up and redeveloped, and is capable of becoming an operating business that provides jobs for the community or will become an asset to the community. Explain how site revitalization will serve to spur further beneficial activities at nearby  5. Assurance of Future. Redevelopment of the Site  organizations, state involvement, city involvement, etc.).  aware oft the project, what are the plans to involve the community?  financial incentives such as TIF's.  6. Benefits  locations.  Describe how site redevelopment will benefit the community. State whether a direct health environmental threat willl be mitigated.  2    BROWNFIELDS AND VOLUNTARY CLEANUP CRITERIA RANKING FORM CDPHE will use this form to evaluate and prioritize applications for brownfields and voluntary cleanup site assessment assistance. In order toj justify CDPHE expenditures on brownfields and voluntary cleanup site assessment activities at sites that are not on CERCLIS, CDPHE is requiring that a set ofcriteria be identified and then evaluated for any proposed assessment assistance. These criteria will also be used by CDPHE to determine where its resources should be directed (e.g., selection and prioritization of one site over another). Each ofthe following criteria isr ranked on a scale oflt to 4, where one is unsatisfactory and four is outstanding. (Foratotal  score of4 40 being the highest.) Rating Criteria  1.Site control and ownership transfer is not an impediment. Site is currently publicly owned either directly by municipality or through a quasi- public entity such as a community development corporation or site is privately owned and a clear means of recouping CDPHE expenditures is available (e.g., through an agreement with the owner or developer or through a lien); for privately owned sites there is a substantial public 2. Strong municipal commitment. A willingness to condemn--take the property ifnecessary. Establishment of financial incentives (e.g., TIFsor other tax incentives). Commitment of municipal resources for other components oft the project (e.g., funding, in-kind services, etc.) 3. Clear municipalcommunty vision and: support for property revitalization. The site is clearly an integral part ofa local development plan, and there is no known public opposition. 4.A Adequate resources andi high developer interest. The municipality or potential site developer has demonstrated an ability to leverage additional funds for cleanup and other future work at the site, and/or the site has strong development potential as demonstrated by past or present interest bya a 5.0 CDPHE assessment assistance is crucial to the redevelopment ofthe site. Lack ofs site assessment is an obstacle to redevelopment, and other resources (federal, state, local, or private) are: not available for assessing the site. 6.7 The iate/Congressiona: members have no objection to. state/federal 7.E Based on existing information, the site is likely to have moderate levels of 8.C Commitments are inj placej for the cleamup and redevelopment of the site 9.R Redevelopment will result in an increase inj jobs for the surrounding 10. Project area has a clear need for revitalization. Existing significant deterioration. Significant environmental. justice issues  benefit.  developer(s).  Proposal should show that there is a strong need. involvement or the redevelopment, project.  contamination.  residents.  3    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested: 06/13/2023 Submitter: Michelle Hiigel, Land Use  Submitted to the County Administration Office on: 06/07/2023 Return Originals to: Michelle Hiigel, Land Use Number of originals to return to Submitter: 0  Contract Due Date: N/A  Item Title/Recommended Board Action:  Consider to approve of Minor Subdivision application by S Bar Ranches, Inc., ini the E2SE4SE4 of Section 19, Township 22, Range 46 West, the 6th P.M. The request is to subdivide the property into three separate tracts. The Property is located in an A-1 Irrigated Agriculture Zoning District. This will bea Second Subdivision. The Planning Commission approved to: forward the application to thel BOCC with  recommendations for consideration of approval on May 24, 2023.  Justification or Background:  S Bar Ranches, Inc., would like to subdivide property into three tracts. Tract A and' Tract B have existing homes, Tract Ci is vacant, but applicant may build a home on thej property in the future. Existing homes are on May Valley Water and North Lamar Sanitation, applicant has obtained approval for water and sewer services from May Valley Water and North Lamar Sanitation for the proposed new home. Fiscal Impact: This item is budgeted in the following account code:  County: $ 350.00 Federal: $  State: $  Other: $  Approved by the County Attorney on: Additional Approvals (if required):  PLEASE ATTACH THIS SHEET' TO ALL AGENDA ITEMS WHEN SUBMITTING TO  COUNTY ADMINISTRATION.  THANK YOU!    SE BAR RANCHES, INC. MINOR SUBDIVISION PLANNING COMMISSION RECOMMENDATIONS  Date of Public Hearing: May 24, 2023 Applicant: SE Bar Ranches, Inc.  Request: Review ofar request by S Bar Ranches, Inc., for a Minor Subdivision in the E% SE44 SE44 Sec.19-122-R46. The request is to subdivide the property into three (3) lots, two with an existing homestead, and one: for aj proposed new. home. The property is located in an A-1  Irrigated Agriculture zoning district.  1. The application was complete, with all requested attachments. 2. Written Notice Mailed (Minimum 15 Days): May 9,2023  3. Mineral Owner Noticed Mailed (Minimum 301 Days): N/A Mineral rights are with thes surface. 4. Barring any discovery at the Public Hearing, iti is the opinion oft the Planning Commission that the applicant has shown compliance with Prowers County Zoning and Subdivision Regulations.  a) The requested use is a use listed as al Use by Review in the Irrigated. Agricultural (A-1) b) The granting of the Minor Subdivision will not substantially modify the intent, purpose or  spirit oft thel Prowers County Master Plan  Recommendations:  1. Prowers County Zoning Regulations for Irrigated Agricultures A-1 single family residences be 2. Written easements agreements to access property be given to each individual tract.  adhered to.  3. Asr recommended by Rural Fire Chief Staffon Warn, ingress/egress access off of highway minimum  of1 121 feet wide.  4. Sewer- North Lamar Sanitation. 5. Water-May Valley Water.  6. Hygiene- Recommend use ofl local trash services.  7. Dust/weed Mitigation.  Planning Commission Recommendations -S Bar Ranches, Inc. Minor Subdivision  Page 1 of1    Map File No.  MINOR SUBDIVISION APPLICATION Please Attach "Letter of! Reques" 10! this Application PLEASE1 READNOTE/ ANDSIGNE BELOW:  THE SUBMITTED APPLICATION PACKAGE REQUIRES SPECIFIC REPORTS/NFORMATION WHICH MAY NOT BE ADEQUATE AS DETERMINED THROUGH THE REVIEW PROCESS. ADDITIONAL INFORMATION MAY BE REQUIRED. ALSO, THE ACCEPTANCE OF TIE APPLICATION PACKAGE DOES NOT MEAN THE SPECIFIC INFORMATION HAS BEEN APPROVED AND IN FINAL FORM. REVISIONS TO THE INFORMATION AND/OR REPORTS MAY BE REQUIRED. REQUESTS_FOR WAIVERS OF ANY OF THESE REOUREMINIEMUSTIE ACCOMPANIED BYALETTER OF JUSTIFICATION. THE PROWERS COUNTY PLANNING COMMISSIONERS WILL HEAR THE WAIVER REQUEST CONCURRENTLY WITH THE APPLICATION. DENIAL OF THE WAIVER REQUEST! SHALL RENDER THIS APPLICATION INCOMPLETE AND RESULTINTHE EQUIREMENTFORANEM SUBMITTAL ACCEPTANCE DATE AND REVIEW PERIOD. YOUR SIGNATURE BELOW INDICATES  ACCEPTANCE OF THESEC CONDITIONS. Date:_ 3242033  mhnphws Apke/Repreal: Signature  Tax parcei number of property (County Assessor's Records) oCWAAIRGAIS,TAS  Is there al Deed of Conscrvation Easement Attached to this property?  Yes No  IfYES, attach copy not be applicable):  Please list the name, address, and telephone number of the following (some may Applicant(s)_ 5Ban Rances, e Address: Po Box 156, Lan, COK10a Telephone Number:719 m-saPate  LEW  Property Owner (s): Some  1 I  Address: Telephone Number:  -  Email:  Applicant's Representative: Monsa Sulpnip Address:_ Po Bes 131, Laxxy.CODa Telephone 1ACWD-BALas Sovye Address of! Property: B37lp HNt 19le  2. Zonc District:  Trvisated Lond  3.: Legal description of the property (ifl lengthy, please attach): altocll 4. Please list any previous applications (e.g. map amendments, zoning variances, special use permits, subdivision variances) in conncction with this property: nenb  Revised: January 13, 2014    Bar Ranches, Inc.  PO Box 1156 Lamar, CO 81052 719-336-9006  Application date: March 24, 2023  Owner:  S1 Barl Ranches, Inc. PO Box 1156 Lamar, co 81052 719-336-9006 Monica Sutphin PO Box 1281 Lamar, Co 81052 719-940-6969 Section 19, T22, R46 Irrigated Land  Representative:  Site Location: Present Zoning:  This letter will request al Minor Subdivision at the above site location. There are two existing homes. One in Tract. A and one in' Tract B and we have possible plans of one more in' Tract C. See attached map. This Minor Subdivision should have no impacts on adjoining properties or county road services. The two existing homes have May Valley Water and North Lamar Sanitation for services. That would be the plan for Tract C1 home as well. The Minor Subdivision would be entered from East Hwy 196 and each' Tract would have ai right of way for the drive way. This property is not located in floodplain. This Minor Subdivision is compatible with the Prowers County Master plan. Thank you for your  consideration of this Minor Subdivision in Prowers County.  Sincerely, Monica  Sutphin SE Bar Ranches, Inc.    3 S  a  - S    EILD  QUITCLAIM DEED  THIS DEEDi is dated December 19.20 22,andismude  between J-S FARMS, INC. (whether one, u murc than one), the "Grantor," of the* County ol PROWERS and  and Statc of COLORADO P.0. BOX 1156 LAMAR, COLORADO 81052 Countyo ol PROWERS  > BAR RANCHES, INC.  (whethere one, orn mure than one), the" "Gruntee," whose legul uddressi is  a aocfer / of Countys  ofd the CONSIDERATION-- PROWERS  ands State of COLORADO DOLLARS,(S 10.00  WITNESS, that the Gruntor, for undi ins consideration ofi thes sume of OTHER GOOD AND VALUABLE the receipt and sufficiency of which is hereby scknowledged, docs hercby rcmise.) relcase. sell: and QUITCLAIM: unto the Gruntee and the Grantee's! hcirs and: assigns, forever, allt the right. title. interest. claim and demand which the Grantor has in  und to the ical property, togcther with any improvements thercon, located in the  and: State of Colorado, described us follows: EXHIBIT "A" ATTACHRD  0  also known bys strceta address as: and assessor'ss schedule or parccl number:  TOHAVEAND1 TOHOLDthes same. together with: alla ands singulart theu ppurtenances) und privileges thereunto or in anywise thereunto mppertnining. andu ull thec cstute. right. title. interest und claim whatsoever oft the Grantor, eitheri belonging. in law or equity, ta the only proper usc, benefit and'b behoof ofthe Grantec, andi the Grantec's heirs anda usigns. lorever. INV WITNESS WHEREOF. the Grantor has. executed this deed ont thes dates seif forth ubove.  J-S hSec. FARMS, INC. BY MONICA SUTPHIN, SECRETARY  STATEOFCOLORADO County of PROWERS  Thei foregoing instrument was ucknawledged hefore mel this I9KL dayaf DECEMBER by MONICA SUTPHIN, SECRETARY OF J-S FARMS, INC.  .20 22  Witress my! handi und officral seal. My egmissin expiresa A 624. ALFREDE BERGQUIST 2000403 MYCOMMS 28,2024 Nane Nu. 933. Rev 1-06, OMTCIAIMDERD  Notuy  cison Crcuting Newly Crented Legal Description (  Bradonl! uhlishing. 1741 Wwyee: SI. Denvei, COR2U2- (36312/2-2510-    Exhlblt "A"  Lots Six (6) ands Seven (7), Block1 1,1 in Speculator Subdivisioni tot the Clty ofLamar, according tot the recorded plat thereof, Parcel No. 1: Atracto oflandr more particularly descrlbed: ast follows, to-wit: Commencing: at Northwest Corner of! Indian Clalm! No. 27, the same being! Inl Township Twenty-two (22) South, Range Forty-six (46), West oft the Sixth Principal Meridian, saldo corner lkewise belng the Northeast Corner ofl Indlan Clalm! No. 26; thence! South 83-20' Easta a distance of 276.4f feet tot the West right-of-way linec oft the Arkansas Valley Branch oft the Atchison, Topeka ands Santa Fel Rallway; thence South 0'37' Easta alongs said right of way! line, a distance of 102.3f feet; thence ont the arc ofac curve tot the right whoser radlus is! 5679.6f feet a distance of 386.6f feet;t thencel North 86'51'V West a distance of25f feet;t thence South 3'09' Westr no distance; thenced ont the arc ofac curvet tot ther righty whoser radlus Is5 5654.6f feet a distance of971.3 feet; thence South: 13°00' West a distance of5 576.1 feet;t thence North 77"00 West a distance of 30f feet;t thence South 13*00' Westa distance of 1355.5 feet; thence South 77*00' East a distance of5 feet; thence South 13*00' West ac distance of412.4 feet; thence North8 89*27' Westad distance of8 860.3f feet; thence Southe 67*03' West a distance of 921.6fe feet; thence North: 30'52' Westa a distance of 385.6f feet toap point, said polnt beingt the Intersection oft the South! boundary! line of said Indlan Claim No.: 26v with the center line oft the! Northa and South County Road throughs said Indian Clalm! No. 26; thence Northerly along the center Iine ofs sald County Roadac distance of 3251.6f feet, toa anl Intersectlon with North boundary! line ofs saidi Indian Clalm No. 26; thence North7 77'44'6 East alongs said North Boundary Line a distance of2 2452 feett tot the Northeast Corner ofs said! Indlan Claim! No. 26 ort thep place oft beginning. Beinga a part ofs said Indlan Clalm! No. 26a and: 27 and generally describeda ast thatp portion ofs sald clalm! lying! between the maln County Road leading Northf from Lamar, Stated of Colorado, and the West Boundary Uine oft the right-of-way oft the Arkansas Valley Branch! hereinbefore  recorded at Reception No. 411911, County ofp Prowers, State of Colorado.  described, EXCEPTINGI however, fromt the above-described premlses, thei following: AR parceic ofl land! belngt thel First Addition tol North! Lamar. oft the Prowers County Colorado Records.  Allo of North Lamar, a Subdivision, together withs streets and alleys adjacent thereto.  A1 tract ofl land as deededt to Boardo of County Commissioners, recorded August 6, 19311 in Book: 229 of Page 1 Two tracts ofl land as deededt to James D. Harper and/ Agnes Marle! Harper, recorded. January3 3,1 1964 at Book 447, Page 136, andi recorded. June 5,1 1975 atE Book: 514, Page 31 oft the Prowers County Clerk and Recorder's 5. A1 tract ofl land as described Ina a deedt tol Lamar Valley Concrete Co., Inc. recorded. July 28, 19661 In Book 464, 6. Atract or parceld ofl land as describedi ina a deed tot the Department ofH Highways, State of Colorado, recorded March: 1,1 1966 InE Book 461, Page 441, oft the Prowers County Clerk and Recorder's Office, County ofProwers, Parcel No. 2: At tract ofl land! InE E1/2 of Sectlon 30, Townshlp: 225 South, Range 461 Westo oft thes Sixth Princlpal Meridian, more particularly described asf follows: Commencing att the Intersection oft the South! line ofl Indian Claim! Number: 26, and1 the East linec ofs said! Section 30; thence West 3101 feet;t thence! Southe 66'58' Westa a distance of 375.5f feet;t thence East 655.5f feet;t thence Northe alongt the sectloni line ofs Section 30 tot the point oft fbeglnning, County ofP Prowers, State of Lots 4,5,6,7,8,9,: 10, 11 of Block 1, Allo of Block2a and Allo of Block 4, of North! Lamar, as subdivislon. Together witht the adjacent vacated streets anda alleys as orderedi bya al Resolution recorded May 15, 1989 at Reception No. 445135 oft the Section 16: Allt that part! lyings South oft ther railroad and EXCEPTING1 thei following described parcels ofl landp prevlously conveyed: By Warranty Deedr recorded August 12, 1893 In Book9a at Page 476; EXCEPTt the West 40f feet of sald Sectlon as conveyed byr right of way deedr recorded! May 27,1 19601 In Book 421, Page! 578; EXCEPTa parcel ofl land conveyed byr right ofv way deed recorded March 4,1 19361 in Book 258 atF Page 397; EXCEPTa parceld ofl land conveyed by Warranty Deedi recorded August 26,: 1895 in Book 9, Page 583 and EXCEPTa  Office.  Page 243, oft the Prowers County Clerka andl Recorder's Office.  State of Colorado.  Colorado.  Prowers County Clerk and Recorderr records, County of Prowers, State of Colorado. Township 235 South, Range 43 West oft the Sixth Principal Merldian    SBar Ranches, Inc.  PO Box 1156 Lamar, CO 81052 719-336-9006  This letter will give notice that S Bar Ranches, Inc. authorize Monica Sutphin to act on owners behalf for the subdivision with the Land Use Board  in Prowers County. I49    Michelle Hiigel From: Sent: To: Cc: Subject: Hi Monica,  Staffon Warn <stwarn@prowerscounty.net> on behalf of Staffon Warn  Tuesday, March 21, 20236:07PM Monica Sutphin Michelle Hiigel; staffon.warn@prowerscounty.net Re: Fw: Attached Image  Ididn't find an attached map. Cany you forward that to me?lhave looked at the location I believe you are referring to and so far don't see any issues. Iwould request that the access off the highway would be a minimum of 121 foot wide for  fire apparatus and enough room tot turn the fire apparatus around to eliminate backing out.  Thank you, Staffon' Warn, Chief Prowers County Rural Fire  OnTue, Mar21, 2023 at 3:25 PMI Monica Sutphin monicasutphin@lyahoo.com>wrote:  Prowers County Rural Fire Department RE: Minor Subdivision/8276 E Hwy 196  Attn: Steffon  Attached is an application for SI Bar Ranches, Inc. for al Minor Subdivision located at 8276 East Hwy 196 in Prowers County. Would this Minor Subdivision cause any concerns or issues fort the Prowers County Rural Fire Department? Please let us know so we may proceed with the application ifiti is approved by your department. Thank  you for your consideration. Monica Sutphin POE Box 1281 Lamar, CO81052 719-940-6969    MAY VALLEY WATER ASSOCIATION APPLIÇATION FOR NEW MEMBERSHIP  Date 32123  Name_ Bar Ronehes, Tnkv  Current Mailing Address_ Ro B0X 15lo LAMAN CO SV0Sa  Phone. 7143B6-000l PROPOSED SERVICE LOCATION Township_ 33 City Loay  Nature of Business (Ifa applicable). Rehidere-  Range_ 4Lo Section, 19  Quarter,  Address_ Balle Ew lalo County Rrooevs  Zip Code 8W52  Billing Address PO Box M5L lowv, COS10S,  Desired Date for Beginning Service. Not Swve  Size of Tap Requested. 8)4" Purpose for Service: Domestic/Household, Other-Specify! Purpose.  (The most common size of tapi is %"andi is used in most residential homes.)  Livestock Facility.  Ihereby request water service from the May Valley Water Assoclation and herewith make appliçation for membership to sald Association. lagree to be bound by the By-Laws of the Association and any amendments thereto together with pollcles of the Association that are established by the Board of Directors. By signing said Application,! understand and: agreet to the' Terms and Conditions" set forthi int the rules and regulations.  wwhse Applicant Signature  Date. 3213  Upona approvall byt thel Board of Directors, the: above: signed-applicant! hereby becomes amemberofthel Mayv Valley Water Association, ar non-profit association organized under the statutes of the State of Colorado, Approval of  this application expires 121 months from the date ofi issue.  Sle May' Valley ater Association  Date 3-31.0023    North Lamar Sanitation District  P.O. Box 1771 Lamar, CO 81052 Dustin DeWitt, Chairman 719-336-4455  March 24, 2023 Dear Customer:  North Lamar Sanitation District should have the capacity to add 1 additional tap at/or near 8276 County Highway 196 Lamar, CO 81052. We need to know more details of location to determine whether we need to add additional main or service lines before final approval.  Ifyou have any questions, please call.  Thank you,  Sve & Dustin DeWitt  Chairman of North Lamar Sanitation District    Proposed Use ofLand Homesteads Proposed Water Source May Valley Water  Proposed Means of Sewage Disposal North Lamar Sanitation Proposed Road Access County Highway 196 Proposed. Lot Size_ approximately 4 acres  The Prowers County Planning Commission recommends approval of this request  forsubdivision exemption. Prowers County Planning Commission, Chair  Dated this  day of  20.  Thel Prowers County Board of County Commissioners grants approval oft this request  forsubdivision exemption.  Prowers County Board of County Commissioners, Chair  Dated this  day of  20  Rovised, July2 22, 2021    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested: 6-13-2023  Submitter: Meagan Hillman, Public Health Director Submitted to the County Administration Office on: 6-7-23 Return Originals to: Meagan Hillman, Public Health Director Number of originals to return to Submitter: 1  Contract Due Date:  Item Ttle/Recommended Board Action: Manager, credit limit at $1000.00. Justification or Background:  Credit Card Authorization Request for Connie Martinez, Environmental Health  Fiscal Impact: This item is budgeted in the following account code:  County: $ Federal: $_ State: Other:  $ $  Approved by the County Attorney on:    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested: 6-13-2023 Submitter: Meagan Hillman, PCPHE Director  Submitted to the County Administration Office on: 05/22/2023 Return Originals to: Meagan Hillman PCPHE Director Number of originals to return to Submitter: 2  Contract Due Date: June 30  Item Tite/Recommended Board Action  Consider approval of Task Order Contract Waiver #154, Amendment #5 to Original Contract No. 2020*0270 between Colorado Department of Public Health & Emergency Preparedness & Response and the Board of County Commissioners of Prowers County for services to improve medical and public health care preparedness, response, and recovery capabilities, funding amount is $42,709 with term ending June 30, 2024 and authorizing Meagan Hillman to execute  the document electronically.  Justification or Background: This is annual Public Health Emergency Preparedness (PHEP) funding from CDPHE. The amount has gone up this year due to restructuring at CDPHE.  Fiscal Impact: This item is budgeted in the following account code:  County: $  Federal: $  State: $  Other: $  Approved by the County Attorney on: 5-22-2023    DocuSign Envelope ID:  DEPARTMENT OF PUBLICHEALTH. AND  ENVIRONMENT CONTRACT ROUTINGI NO.  CT 2020*270  APPROVED TASK ORDER CONTRACT - WAIVER #154  This lask order contract isi issued pursuant to master contract made on 11/23/2016, with routing number 181 FAA 00042.  STATE:  CONTRACTOR: Board ofCounty Commissioners of Prowers County (apoliticals subdivision oft the state ofColorado) 301 Southl Main Street, #215 Lamar, Colorado 81052 for the use andb benefit ofthe Prowers County Public) Health 1001 South! Main Street Lamar, Colorado 81052-3838 CONTRACTORI DUNS: 14854343 CONTRACTOR ENTITY TYPE: Political Subdivision BILLING STATEMENTS RECEIVED: Monthly STATUTORY, AUTHORITY: Not. Applicable CLASSIFICATION: Subrecipient  State ofColorado fort the use & benefit ofthe Department ofPublic Heaitha and Environment Offiçe of Emergency Preparedness andl Response 4300 Cherry Creek South Drive Denver, Colorado 80246  CONTRACT MADE DATE: 5/1/2019  TERM:  This contract shall bee effective upona approval by the State Controller, or designee, or on 07/01/2019, whicheveri isl later. The contract shall end on 06/30/2020.  PROCUREMENTY METHOD: Exempt IDREPAISTPRICEAORFEMENTNUMBEK N/A LAWSPECIEDVENDORS STATUTE; N/A STATEREPRESENTATIVE, Melanie Simons PHEP Grant Branch Manager Colorado Dept. of Public Health and Environment Office of Emergency Preparedness and Response 4300 Cherry Creek South Drive Denver, Colorado 80246 PROJECT DESCRIPTION: radiological events, Task Order CMSI Number: 129553 Contract Routingl Number: CT 2020*270  CONTRACT PRICE NOT: TO EXCEED: $21,180.00 STATEFUNDNGDOLAIS $0.00  FEDERAL! OTHER MAXIMUMI AMOUNTA FY20: PRICESTRUCTURE: CONTRACTORF REPRESENTATIVE: Meagan Hillman Prowers County Public Health 1001 South Main Street Lamar, Colorado 81052-3838  $21,180.00 $0.00 Specify" "Other": $0.00  $21,180.00 Cost Reimbursement  The PublicI Hcalth Emergency Preparedness Program (PHEP) supports public health departments across the nation to upgradc their ability to cffoctively respond toar range ofp public healtht threats, including infectious discases, natural disasters, and biological, chemical, nuclear, and  Page 1of23    DocuSign Envelope ID:: 330BC97E-A4F0-4F0-4522-B0A3-29694E90A9BF  CONTRACT AMENDMENT #5 SIGNATURE AND COVER PAGE(S)  State. Agency:  Original Contract Number: 2020*0270  Colorado Department Of Public Health and Environment  4300 Cherry Creek Drive South Denver, Colorado 80246 Contractor:  Amendment Contract Number: 2024*0106 Amendment #5  Board of County Commissioners of Prowers County (aj political subdivision oft the state of Colorado) 301 South Main Street, #215 Lamar, Colorado 81052 for the use and benefit of the Prowers County Public Health 1001 South Main Street Lamar, Colorado 81052-3838 Contract Performance Beginning Date:  Current Contract Expiration Date: June: 30, 2024  July 1,2019 Document Type Original Contract Contract Contract Contract Contract Contract  CONTRACT MAXIMUM AMOUNT TABLE  Contract Number Federal  State Funding Other Funding Term (dates)  Total $21,180.00 $0.00 $20,424.00 $20,382.00 $19,992.00 $42,709.00  Funding Amount $21,180.00 $0.00 $0.00  Amount  Amount $0.00 $0.00 $0.00 $0.00 $0.00 $0.00  2020*0270 2020*0270 2020*0270 2022*0111 2023*0207 2024*0106  07/01/2019- 06/30/2020 07/01/2019- 06/30/2020 07/01/2020- 06/30/2021 07/01/2021- 06/30/2022 07/01/2022- 06/30/2023 07/01/2023- 06/30/2024 Current Contract Maximum $124,687.00 Cumulative Amount  $0.00  Amendment #1 Amendment #1 Amendment #2 Amendment #2 Amendment #3 Amendment #3 Amendment #4 Amendment #4 Amendment #5 Amendment #5  $20,424.00 $0.00 $20,382.00 $0.00 $19,992.00 $0.00 $42,709.00 $0.00  Page 1of4  Amendment Contract Number: 2024*0106. Amendment #5  Ver01.11.19    DocuSign Envelope ID: 330BC97E-A4F0-4F0-4522-B0A3-29694E90A9BF  SIGNATURE PAGE  THE PARTIES HERETO HAVE EXECUTED THIS. AMENDMENT  Each person signing this Amendment represents and warrants that he or shei is duly authorized to execute this Amendment  and to bind the Party authorizing his orl her signature.  CONTRACTOR Board of County Commissioners of Prowers County (ap political subdivision oft thes state of Colorado) fort the use and' benefit ofthe Prowers County Public Health  STATE OF COLORADO Jared S. Polis, Governor Colorado Department of Public. Health and Environment Jilll Hunsaker Ryan, MPH, Executive Director  By: Signature  By: Signature  Meagan Hillman Director  Name of Executive Director Delegate Title of Executive Director Delegate  Name ofl Person Signing for Contractor Title of Person Signing: for Contractor  Date:  Date:  Ina accordance with $24-30-202 C.R.S., this Contract is not valid until signed and dated below by the State Controller or  an authorized delegate. STATE CONTROLLER Robert Jaros, CPA, MBA, JD  By: Signature  Name of State Controller Delegate Title of State Controller. Delegate  Amendment Effective Date:  Signature and Cover Pages End --  Page2of4  Amendment Contract! Number: 2024*0106. Amendment #5  Ver. 06,05.20    DocuSign Envelope ID: 330BC97E-A4F0-4F0-4522-80A3-29694E90A9BF  PARTIES State. 2. TERMINOLOGY  This. Amendment (the "Amendment') to the Original Contract shown on the Signature and Cover Page for this Amendment (the "Contract") is entered into by and between the Contractor, and the Except as specifically modified by this Amendment, all terms used in this Amendment that are defined in the Contract shall be construed and interpreted in accordance with the Contract.  3. AMENDMENT EFFECTIVE DATE AND' TERM  A. Amendment Effective Date  This Amendment shall not be valid or enforceable until the Amendment Effective Date shown under the State Controller Signature. The State shall notl be bound by any provision of this Amendment before that Amendment Effective. Date, and shalll have no obligation toj pay Contractor for any Work performed or expense incurred under this Amendment either before  or after of the Amendment term shown in $3.B oft this Amendment.  B. Amendment Term  The Parties' respective performances under this Amendment and the changes to the Contract contained herein shall commence on the. Amendment Effective Date shown under the State Controller Signature or July 1, 2023, whichever is later, and shall terminate on the  termination oft the Contract or June 30, 2024, whichever is earlier.  PURPOSE  The Parties entered into the agreement to upgrade the public health departments ability to effectively respond to a range of public health threats, including infectious diseases, natural The Parties now desire to renew for an additional term and change current Contract Maximum Total for the: following reason: To update the contract documents and requirements for fiscal  disasters, and biological, chemical, nuclear, and radiological events.  year 2024. 5. MODIFICATIONS  The Contract and all prior amendments thereto, if any, are modified as follows:  A. The Contract Maximum Amount table is deleted and replaced with the Current Contract Maximum Amount table shown on the Signature and Cover Page for this Amendment. B. The Contract Initial Contract Expiration Date on the Contract's Signature and Cover Page is hereby deleted and replaced with the Current Contract Expiration Date shown on the C. The Parties now agree to modify Exhibit C, Budget, oft the agreement. Exhibit C, Budget, is deleted and replaced in its entirety with Exhibit C, Budget, attached to this Amendment D. The Parties now agree to modify Exhibit E, Statement of Work, oft the agreement. Exhibit E, Statement of Work, is deleted and replaced in its entirety with Exhibit E, Statement of  Signature and Cover Page for this Amendment.  for the following reason: Toi issue the fiscal year 2024 Budget.  Page3of4  Amendment Contract Number: 2024*0106. Amendment #5  Ver27.01,20    DocuSign Envelope ID: 330BC97E-A4F0-4F0-4522-80A3-29694E90A9BF  Work, attached to this Amendment for the following reason: To issue the fiscal year 2024 E. The Parties now agree to modify Exhibit F, Federal Provisions. Exhibit F, Federal Provisions, is deleted and replaced in its entirety with Exhibit F, Federal Provisions, attached to this Amendment, for the following reason: To reflect changes to the federal  Statement of Work.  award identification information.  6. LIMITS OF EFFECT AND ORDER OF PRECEDENCE  This Amendment is incorporated by reference into the Contract, and the Contract and all prior amendments or other modifications to the Contract, ifany, remain in full force and effect except as specifically modified in this Amendment. Except for the Special Provisions contained in the Contract, in the event of any conflict, inconsistency, variance, or contradiction between the provisions oft this Amendment and any ofthe provisions ofthe Contract or any prior modification to the Contract, the provisions of this Amendment shall in all respects supersede, govern, and control. The provisions of this Amendment shall only supersede, govern, and control over the Special Provisions contained in the Contract to the extent that this Amendment specifically  modifies those Special Provisions.  Page4 4of4  Amendment Contract Number: 2024*0106. Amendment #5  Ver27.01.20    Exhibit C  DocuSign Envelope ID: 330BC97E-A4F0-4F0-4522-80A3-29694E90A9BF  COLORADODEPARTMENT, OFF PUBLICH HEALTHA ANDE ENVIRONMENT (CDPHE) DISEASE CONTROL ANDF PUBLICI HEALTH RESPONSE (DCPHR)  12-MO BUDGET  Agency Contact Name, Title Jol Lynn Idler, EPRO Coordinator Fiscal Contract Name, Title Meagan Hillman, PHD Director  Agency Name Budget Period Project Name  Prowers County Public Health FY24 PHEP  Phone Email Phone Email Date Completed  (719); 336-87216 ext:211 iderepowerounvy.net (719) 336-8721 ext2 212 imnepowexcounye 4/14/2023  Allb budgetr numbers aree estimates  Gross or Annual Salary $ 108,055.92 $ 20,478.72  Percento of Total Amount Fringe Timeon Requested Project 7% $ 8,997.42  Position Title  Description ofv Work  Public Health Director Oversees allP Public Health Functions Response Coordinator Emergency Preparedness Response Deliverables  Emergency Preparedness Coordinates alll Emergency Preparedness Response Activities ando Oversee all $ 54,600.00 $ 14,967.84 20% $ 13,913.57  Public Health! Nurse, Bachelor's of Science Nurse, Registered Nurse  Responsible for Epidemiology Deliverables aso outlined in SOW  $ 69,638.40 $ 17,019.72 13% 11,265.56  Total Personnel Services $ 34,176.55 (including fringeb benefits) Total Amount Rate Units Requested 450.00 10.00 20$ 200.00 $ 3.60 15 $ 54.00 $ 49.99] $ 349.93 Total Supplies $ 1,053.93 &Operating Expenses Total Amount Rate Units Requested 420.00 0.70 475 $ 332.50 $ 15.99 15$ 239.85 Total Travel $ 992.35 Total Amount Rate Units Requested 50.00 38$ 1,900.00  Supplies & Operating Expenses Description oflt Item  Item  Conference Registration Registration for Emergency Preparedness Response Coordinatort to attend Colorado Emergency $ 450.00  Management Association Conference  General Office Supplies Copies, IDE Badges, Misc. office Supplies  Volunteer Insurance Food/Snacks  Clinical and1 Translational Sciences Institute Volunteer Insurance Light meals/snacks providedf fora attendees ofr meetings ande exercises  Travel Description ofl Item  Item Lodging Mileage Meals  Regional/State Meetings, Conferences: andT Trainings for Public Health Director: and Emergency $ 140.00 Travelf for Public Health Director and Emergency Preparedness Response Coordinator to attend $ Meetings, Conferences: and Trainingf for Public Health Director and Emergency Preparedness  Preparedness Response Coordinator Local/Regional/State meetings, conferences andt trainings  Contractual (payments tot third parties or entities) Description ofl Item  Subcontractor Name  MEP1 Trained Individual** Ani individualf from thes Southeast Regionv willl bel hiredt to Plan, Develop, Implement and Document  any exercises needed tor meet contract deliverables. This would alsoi include: anyr reale events. **We have multiple MEP trained peoplei inc ourr region, we cand contract with, sor nor namei is specified  Total Contractor/Consulants, $ 1,900.00 TOTALDIRECTCOSIS (TDC)$ 38,122.83 Contractor ine excess of $25,000 $ Other Unallowable Expenses $ TOTAL DIRECTCOSTS) for indirect calc  Less: Expenses notp part ofi indirect calculation  Rent $ Equipment $ Totall $  38,122.83  Indirect Costs  Amendment Contract Number: 2024*0106. Amendment #5  Page 1of2    Exhibitc Total Amount Percentage Requested $  DocuSign Envelope ID: Indirect Cost Rate Federaly-Negotatedi Rate  Description ofl Item  Modified Total Direct Cost (MIDC): MTDCr means allo directs salaries andy wages, applicable fringe! benefits, materials ands supplies. 12.03% $ 4,586.18  services, travel, andi up tot thef first$ $25,0000 ofe eachs subaward (regardless oft they period of performance oft thes subawards under scholarshipsa andf fellowships, participant supporto costs andt they portion ofe eachs subawardi ine excess of$25,000.  CDPHE- Negotiated Rate the award). MTDC excludes equipment, capitale expenditures, charges forp patient care, rentalc costs, tuition remission,  10% Den Minimis Rate  Totall Indirect $ 4,586.18  TOTAL Amount Requested from CDPHE $ 42,709.00  Amendment Contract Number:: 2024*0106 Amendment: #5  Page 2of2    DocuSign Envelope ID:  EXHIBITE  STATEMENT OF WORK To Original Contract Number: 2020*0270  These provisions are tol be read and interpreted in conjunction with the provisions of the contract specified above.  I.  Project Description:  This project serves to improve medical andj public health care preparedness, response, recovery and epidemiological capabilities at the federal, state, and local levels. Public health systems are essential inp preparing communities toi respond to and recover from emergencies and threats. Centers for Disease Control and Prevention (CDC) established the PHEP program to build public health The! Public Health Emergency Preparedness (PHEP) cooperative agreement provides techniçal assistance and resources to support state, local, Tribal, and territorial public health departments, along withl Healthcare Coalitions (HCCs) and health care organizations, throughout Colorado to show measurable and sustainable progress towards achieving the preparedness and response capabilities that promote prepared and resilient communities through planning, training, and  emergency response capabilities both nationally and locally.  exercises. Definitions: 2023  II.  1.A AFN-Access and Functional Needs 2. CDC-Centers for Disease Control and Prevention  3. CEDRS-Colorado Electronic Disease Reporting System, will be replaced by EpiTrax in the Winter of  4. CDPHE-Colorado, Department ofl Public Health and Environment 5. CO-SHARE-Colorado State Health and Readiness Exchange 7. DHSEM-Division ofHomeland Security and Emergency Management  6. CVM-Colorado Volunteer Mobilizer 8. DOC-Department Operations Center 10. EPR-Emergency Preparedness and Response 11. HAN-Health Alert Network 12. HCC-Healthcare Coalition 13. IPP-Integrated: Preparedness Plan 14. LPHA-Local Public Health Agency 15. LTP-Local Transfer Point 17. NORS-National Outbreak Reporting System 18. OEPR-Office of Emergency Preparedness and) Response 19. PHEP-Public Health Emergency Preparedness 20. POD-Point of] Dispensing 21. RSS-Regional Stage and Storage 22. RTP-Regional Transfer Point  9. EpiTrax- Disease reporting and surveillance system tol be implemented replacing CEDRS in the Winter  of2023  16. Mission Drils-Emergency response drills for medical and public health professionals  Amendment Contract Number: 2024*0106 Amendment #5 Page 1of9    DocuSign Envelope ID: 330BC97E-A4F04F0-4522-B0A3-29694E90A9BF  EXHIBITE  II. Work Plan:  Goal #1: Toi increase capacity for preparedness and epidemiology response and recovery within the. Jurisdiction. Objective #1: Nol later than the expiration date of the Contract, provide public health preparedness, response, and recovery surveillance response activities, to maintain public health surveillance and epidemiological response  capacity in the. Jurisdiction through planning, training, exercises and real events. Primary Activity #1 implement appropriate disease control and mitigation activities.  The Contractor shall conduct timely, complete disease and outbreak investigations to 1.The Contractor shall create aj plan to maintain access to the following trained personnel. Plans currently in use, do not need tol bei recreated but can be updated. Plans must include a. Staffw who monitor routine jurisdictional public health disease surveillance system; Colorado Electronic Disease Reporting System (CEDRS/EpiTrax). b. Staff who are trained to conduct routine disease investigations. . Staffwho can support surge requirements int response to disease-related events. d. Staff who cani respond to emergencies that threaten public health. 1.The Contractor shall maintain complete, accurate disease outbreak investigation data. a. The Contractor shall enteri information from thel Local Public Health Agency LPHA)-conducted disease and outbreak investigations into the designated .D Data entry shall be completed within three business days ofinvestigation or  the following items:  Sub-Activity #1  Sub-Activity #2  statewide surveillance. system CEDRS/Epilrax).  interview.  1.The Contractor shall assess disease investigation metrics reports. a. The Contractor shall resolve any issues identified ini the reports. b. The Contractor shall record each disease investigation metrics issue resolution in 1.The Contractor shall submit timely, complete Outbreak Reports for LPHA led outbreaks  Sub-Activity #3  the Grant Reporting Spreadsheet.  for the following reports: a. Initial Outbreak report. b. Final Outbreak report.  Sub-Activity #4  1.The Contractor shall submit timely, complete National Outbreak Reporting System (NORS) forms for the following outbreaks led by thel LPHA: a. Waterborne and foodborne disease outbreaks. b. Enteric disease outbreaks which transmission methods include: i. contact with environmental sources, ii. through infected people or animals, ili. ani indeterminateumknown mode.  Sub-Activity #5  1.The Contractor shall respond toi incidents with public health implications within the The Contractor shall assess specific public health surveillance data to assist with the prompt identification of potentially hazardous health situations to enable rapid decision making and information sharing for the protection of community health.  Sub-Activity #6 jurisdiction toi implement appropriate disease control and mitigation activities.  Primary Activity #2  Amendment Contract Number: 2024*0106. Amendment #5 Page 20f9    DocuSign Envelope ID: 330BC97E-A4F0-4F0-4522-B0A3-29694E90A9BF  EXHIBITE  1. The Contractor shall maintain awareness of communicable disease trends and threats in a. The Contractor. shall regularly assess surveillance data for theirj jurisdiction. b. The Contractor shall regularly review surveillance data for theirj jurisdiction. The Contractor shall attend statewide Communicable Disease calls. d. The Contractor shall meet at least quarterly with the Field Epidemiologist assigned  their jurisdiction.  Sub-Activity #1  tot their region. a. Reports. b. Concepts.  1.The Contractor shall present public health surveillance datai to include: (6) months. Examples oft topics include, but are not limited to: a. Public health surveillance data through ai newsletter b. Public health surveillance data through a website. Discussing the agency's regional epidemiological response plan. d. Reviewing an outbreak investigation. Reviewing the role ofe epidemiology in emergency preparedness and response. f. Sharing epidemiological tools that can be used in emergency preparedness and g. Training for HCCS to address identified gaps in communicable disease 3.The Contractor shall submit reports toi the Grant Reporting Spreadsheet to include  2.The Contractor shall share data with community organizations, at ai minimum of every six  Sub-Activity #2  response. response. thei following: a. The date of the presentation. b. Al BriefTopic Synopsis.  The Contractor shall support disease prevention and response among people at 1.The Contractor shall coordinate with community stakeholders that shalli include agencies  Primary Activity #3 higher risk of communicable disease infections.  such as:  a. Organizations supporting people experiencing homelessness. b. Correctional facilities. . Organizations supporting populations >65 years. d. Organizations supporting food security. Schools. Childcare agencies. Organizations supporting seasonal workers. h. Organizations supporting migrant workers. Organizations supporting people with disabilities. Organizations supporting people with chronic conditions.  Sub Activity #1  Goal #2: To increase capacity for preparedness, response, and recovery during public health emergencies. Objective #1: Nol later than the expiration date of the Contract, improve public health preparedness, response, and Primary Activity #1 Integrated Preparedness Plan (IPP) to include four years of progressive exercise planning.  recovery activities through planning.  The Contractor shall participate in the development or update oft thel Regional All-Hazards  1.1 The Contractor shall complete one of the following: a. The contractor shall update their existing plan. b, The contractor shall develop a new plan.  Sub-Activity #1  Primary Activity #2 The Contractor shall develop or update the Distribution Plan.  Amendment Contract Number: 2024*0106. Amendment #5 Page30f9    DocuSign Envelope ID: 330BC97E-A4F0-4F0-4522-80A3-29694E90A9BF  EXHIBITE  1.Updates to the plan shall include the following: a. Ordering process, b. Transportation methods, Storage details, d. Supply management, Point of contact(s), Facility address.  Sub-Activity #1  The Contractor shall meet with the local Emergency Manager to discuss planning and The Contractor shall assure collaboration with at least one (1) oft the following: a. Fatality management partners in their jurisdiction. b. Mass care partners int the jurisdiction. 1.The Contractor shall participate in one oft thei following events: sharing, coordination and] key response roles. coordination and key response roles.  Primary Activity #3 Public Health/Emergency, Management coordination during responses at least once per  quarter.  Primary Activity #4  a. Attend an existing meeting with these partners to confer about information b. Hold a meeting with these partners to confer about information sharing,  Sub-Activity #1  Objective #2: No later than the expiration date of the Contract, improve public health preparedness, response, and  recovery activities through training.  The Contractor shall participate inj public health preparedness, response, or recovery The Contractor shall identify staff who have been trained as primary and alternate The Contractor shall participate in an' "Ordering and) Receiving" CDPHE Developed The Contractor shall participate in at least one training event or informational meeting offered by thel Division ofHomeland Security and Emergency Management (DHSEM)  Primary Activity #1 related conferences at the discretion of the Contractor. Primary Activity #2 Colorado Volunteer Mobilizer (CVM) administrator.  Primary Activity #3 webinar once per fiscal year.  Primary Activity #4 Access and Functional Needs (AFN)Team.  The Contractor shall develop an. ESF 8 resilience plan.  Primary Activity #5  1.The Contractor. shall implement a one (1) day consultation with the CO-CARES team at  Sub-Activity #1 CDPHE tol learn about ways to strengthen individual, team ands system resilience. Objective #3: Nol later than the expiration date of the Contract, improve public health preparedness, response, and  recovery activities through exercises. Primary Activity #1  The contractor shall respond to quarterly redundant communication drills.  1. Responses tot the Office of Emergency Preparedness and Response (OEPR) drills may  be made by one or more oft the following methods:  a. Email. b. Phone. C. SMS Text. d. Radio.  Sub Activity #1  Amendment Contract Number: 2024*0106 Amendment 5 Page4of9    DocuSign Envelope ID:: 330BC97E-A4F0-4F0-4522-80A3-29694E90A9BF  EXHIBITI E  2. Responses toi the Communicable Disease drills may bei made by one or more oft the  following methods: a, Email. b. Phone. C. SMS Text. d. Radio.  The Contractor shall update the LPHA Contact Listi in the Colorado Statel Health and 1. The Contractor shall update the contact list ai minimum oft two (2) times per year or b. New Emergency Preparedness and Response (EPR) staff are added.  Primary Activity #2 Readiness Exchange (CO-SHARE).  when:  a. Contact information changes.  Sub Activity #1  Primary Communicable Disease staff change.  The Contractor shall participate in quarterly redundant 800 MgHz radio communication The Contractor shall update and maintain jurisdictional contact lists for communication 1.R Redundant communication system contact lists shall bel kept up-to date. Systems may  Primary Activity #3 drills conducted by CDPHE. Primary Activity #4 with local partners.  include but not be limited to: a. The Health. Alert Network (HAN): message system, b. Exercise and drills spreadsheets, Other jurisdictional tracking systems.  Sub Activity #1  1. The Contractor shall utilize contact lists to receive and distribute relevant public health  Sub-Activity #2 and epidemiological information.  1. The Contractor shall submit HAN: reports twice per year.  Sub-Activity #3  The Contractor shall conduct semi-annual drills to1 test redundant forms of communication The Contractor shall utilize the Colorado Volunteer Mobilizer (CVM) system for disaster 1.T The Contractor: shall conduct ai minimum of two (2) of the: following events that include  Primary Activity #5 among its partners. Primary Activity #6 drills and events.  all the Volunteers under the Administrator:  a. Mission drills b. Real events  Sub Activity #1  2.The Contractor shall use the CVM: system for scheduling mission drills. 3.7 The Contractor shall use the CVM: system for real disaster events.  The Contractor shall conduct a distribution Tabletop exercise utilizing CDPHE, guidance  Primary Activity #7 document.  Amendment Contract Number: 2024*0106. Amendment #5 Page 50f9    DocuSign Envelope ID:  EXHIBITE  1. The content of electronic documents located on CDPHE and non-CDPHE websites and information contained on CDPHE and non-CDPHE websites may be updated periodically during the contract term. The contractor shall monitor documents and website content for 2. CDPHE will provide al location to access the Grant Reporting Spreadsheet. 3.T The Contractor shall comply with primary disease case investigation responsibilities for local or state public health agencies and the public health response timelines outlined in the CDPHE Communicable Disease. Manual htpsi/cdphecoloradogow/communcane disease-manual) int the "CDPHE Guidance on. Diseases Needing Case Investigation" mpabsggeamdamewAMMAMPMARONSNCMANNOT 1QxMOPM/edit). This document and website are incorporated and made part oft the contract by reference and are available ont the following website: htps/edphecoloradoovcommunicable-disease-manual  updates and comply with all updates.  4. The Contractor shall use statewide guidance and best practice ini investigation of disease and outbreak. Guidance for many conditions can be found int the CDPHE Communicable Disease Manual ntps/edphe.coloradondogovcommuncanedisease-manual. Guidance may evolve and be adapted for changing responses or new pathogens. This website is  incorporated andi made part of the contract by reference.  a. CDPHE CDB will provide the most up to date guidance as needed. 5.The Contractor shall comply with CDPHE: requirements in the use of CEDRS and EpiTrax for data reporting including complete data entry for required fields.  Standards and  Requirements 6.The Contractor shall comply with reporting requirements when completing the Center  for Disease Control and Prevention (CDC) National Outbreak Reporting System (NORS) forms and Outbreak Reports. This information is incorporated and made part oft this htpsy/dphscolomdogonfstisudisaeasautirsakinsstigationguidcines 7. The Contractor shall complete disease and outbreak investigations with primary reporting responsibilities using established guidance and best practices. 8. The contractor shall not distribute public health surveillance data for counties outside of theirj jurisdiction without prior written approval from thej jurisdiction whose datai is  contract by reference and is located on1 the CDPHE website:  requested. Approval will allow the following:  a. The extraction of data from another jurisdiction. b.D Downloading another jurisdictions Data. c. The analysis ofI Data obtained from another jurisdiction. d. Interpreting another jurisdictions data.  9. The Contractor shall attend ai minimum of 80% of the bi-monthly epidemiologist 10. CDPHE will record and monitor attendance of the bi-monthly epidemiologist 11.CDPHE will supply disease reporting and investigation metrics reports in August 2023 12. The Contractor shall comply with CDPHE requirement for outbreak reporting.  conference calls. conference calls. and February 2024.  Amendment Contract Number: 2024*0106. Amendment #5 Page 6of9    DocuSign Envelope ID: 330BC97E-A4F0-4F0-4522-B0A3-29694E90A9BF  EXHIBIT) E  13. The Contractor. shall demonstrate participation in the Regional All-Hazards Integrated  Preparedness Plan (IPP) by one ofthe following: a. Retaining sign-in sheets, b. Providing meeting minutes, C. Sharing an email.  14.CDPHE shall provide a guidance document for quarterly meetings between Public 15. The Contractor CVM administrators, both primary and alternate shall: a. Have completed CVM. Administrator training within the past 241 months. b. Signed the yearly confidentiality agreement. C.B Be recognized by CDPHE as a CVM. Administrator. 16. CPDHE will provide quarterly CVM. Administrator training for LPHA's. 17. CDPHE will provide ESF 8 development guidance by. July316:2023. 18. A minimum ofo one (1) EPR Coordinator per agency must respond to the quarterly a. Redundant Communication Drills (radios) will focus on the following: b. Information sharing between the state and local department operations centers Communication between the Regional Stage and Storage (RSS), Regional Transfer Point (RTP) and Local Transfer Point (LTP)s.  Health and Emergency Management partners.  redundant communication drills conducted' by CDPHE.  (DOC).  19. CDPHE will provide access tot the Communication Drill Reporting Spreadsheet via  COSHARE.  20. Local operational sites include the following: a. DOC b. Open Point of] Dispensing (POD) C. Closed POD d. RTP LTP - HCC member agencies  21. CDPHE will provide guidance for Tabletop exercises by September 30th, 2023. emergencies andi related events to which a public health response is necessitated.  Expected Results of Colorado public health agencies willi improve their ability to respond to public health  Activity(s)  1. NORS forms are complete. 2. Outbreak Summary Reports are complete.  3. Disease investigations conducted by the Contractor are timely and complete. 6. Improved collaboration between public health and emergency management. 7. Participation in Emergency Preparedness drills and exercises.  Measurement of 4. Grant Reporting spreadsheet is complete for all deliverables. Expected Results 5. Updated Regional All-Hazards Integrated Preparedness Plan (IPP).  8. Updated Distribution Plan.  Amendment Contract Number: 2024*0106 Amendment #5 Page 70f9    DocuSign Envelope ID: 330BC97E-A4F0-4F0-4522-B0A3-29694E90A9BF  EXHIBITE Completion Date Sept. 30, 2023 for first submission, Dec. 31,2023 for second submission, March 31,20241 for third submission, and June 15, 2024: for the fourth submission No later than September 30, 2023 No later than Dec. 31,2023 for the first submission and June 15, 2024 fort the second submission No later than June 15, 2024 No later than. June 15, 2024 No later than No later than Nol later than  1. The Contractor shall submit the meeting minutes from No later than  quarterly meetings via CO-SHARE.  2. The Contractor shall submit their personnel plan identifying how they will maintain access tot trained personnel to the CDPHE Contractor via CO-SHARE. 3. The Contractor shall submit all agency- initiated drill report information ini the Communications Drill Reporting Spreadsheet via CO-SHARE. 4. The Contractor shall submit documentation of participation in the development of the Regional All- Hazards Integrated Preparedness Plan (IPP)via CO- 5. The Contractor shall submit the Distribution Plan via 6. The Contractor shall submit an agenda and meeting 7. The Contractor shall submit copies of CVM agreements for their primary and alternate administrators via CO-SHARE. 8. The Contractor shall submit the date and time of the  Deliverables  SHARE. CO-SHARE. SHARE.  minutes for collaboration sessions with partners via CO- June 15,2024 administrator training certificates with confidentiality June 15, 2024 CDPHE webinar completed into the Grant Deliverable June 15,2024 9. The Contractor shall submit the sign ins sheet(s) for the No later than DHSEM AFN training events or informational meetings June 15,2024 10. The Contractor shall submit all contact list(s) via CO- Nol later than 11. The Contractor shall submit a draft ESF8 resilience plan No later than 12. The Contractor shall submit CVM: reports for two (2) No later than completed mission drills or real events via CO-SHARE. June 15, 2024 13. The Contractor shall submit an exercise plan, participant No later than list, and after action report via CO-SHARE. 14. The Contractor shall resolve issues related to missing  Tracker. via CO-SHARE. SHARE. via CO-SHARE.  June 15, 2024 June 15, 2024 June 15. 2024 No later than two (2) missing datai report No later thani two months from first illness onset  datai in CEDRS or Epi Traxi for conditions investigated weeks after receivinga  by thel LPHA.  15. The Contractor shall submit NORS forms for outbreak reporting via CO-SHARE.  Amendment Contract Number: 2024*0106. Amendment: #5 Page 8of9    DocuSign Envelope ID: 330BC97E-A4F0-4F0-4522-B0A3-29694E90A9BF  EXHIBITE No later than six (6) months from first illness onset No later than one (1) business day from identification No later than two (2) weeks from notification of missing ori incomplete reports from CDPHE Nol later than one (1) month after receiving the report No later than Feb. 28, 2024 No later than the contract end date No later than the contract end date  16. The Contractor shall submit outbreak summary reports forLPHA led outbreaks via CO-SHARE. 17. The Contractor shall report outbreaks identified in theirj jurisdiction to CDPHE via CO-SHARE. 18. The Contractor shall resolve issues related to timely and complete submission ofl NORS forms and outbreak reports via CO-SHARE.  19. The Contractor shall submit documentation of any issues identified ini the disease investigation metrics reports and resolution via the Grant Reporting 20. The Contractor shall submit the name of the public health or community organization" to whicha surveillance or epidemiologic topic was presented between July 1, 2023 and December 31,2023, via the Grant Reportings spreadsheet. 21. The Contractor shall submit the name of the public health or community organization to whicha surveillance or epidemiologic topic was presented between January 1,2024 and. June 30, 2024 via the Grant Reporting spreadsheet. 22. The Contractor shall submit al brief summary oft their role in disease prevention and response efforts among people ofl higher risk of communicable disease infection viai the Grant Reporting  Spreadsheet.  spreadsheet.  IV. Monitoring:  CDPHE's monitoring oft this contract for compliance with performance requirements will be conducted throughout the contract period by the program monitor. Methods used will include ai review ofd documentation determined by CDPHE to be reflective of performance to include progress reports and other fiscal and programmatic documentation as applicable. The Contractor's performance will be evaluated at set intervals and communicated to the contractor. A Final Contractor Performance Evaluation  will be conducted at the end oft the life oft the contract. V. Resolution of Non-Compliance:  The Contractor will be notified in writing within 30 calendar days of discovery of a compliance issue. Within 10 calendar days ofdiscovery, the Contractor and the State will collaborate, when appropriate, to determine the action(s) necessary to rectify the compliance issue and determine when the action(s) must be completed. The action(s) and timeline for completion will be documented in writing and agreed to by both parties. If extenuating circumstances arise that require an extension to the time line, the Contractor must email a request to the Public Health Emergency Preparedness (PHEP). Program Manager or designee and receive approval for ai new due date. The State will oversee the competommp.emematon of the action(s) to ensure time lines are met and the issue(s) is resolved. If the Contractor demonstrates inaction or disregard: for the agreed upon compliance resolution plan, the State may exercise  its rights under the Terms and Conditions of this contract.  Amendment Contract Number: 2024*0106. Amendment #5 Page 90f9    DocuSign Envelope ID: 30BC97EA4F0462280AS280AE9OAPE:  Exhibit F  Federal Provisions - Public Health) Emergency Preparedness  For the purposes oft this Exhibit only, Contractor is alsoi identified as" "Subrecipient." This Contract has been funded, in whole ori inj part, with an award of Federal funds. Ini the event ofa conflict between the provisions oft these Supplemental Provisions for Federal Awards, the Special Provisions, the Contract or any attachments or exhibits incorporated into andi made aj part of the Contract, the Supplemental Provisions for Federal Awards shall control. Ini the event ofa conflict between the Supplemental Provisions for Federal Awards and thel FFATA Supplemental Provisions (ifany), the FFATA  Supplemental Provisions shall control. 1) Federal Award Identification.  a. Subrecipient: Prowers County Public Health b. Subrecipient Unique Entity Identification Number: d. Thel Federal award date is 6/22/2022  SAMI Unique Entity ID (UEI): Y8C4HSXY95M6 C. Thel Federal Award Identification Number FAIN)ENUPOT922025  The subaward period of performance start date is 7/01/2019 and end datei is 6/30/2024.  Federal Funds: Federal Budget Period 07/21/2022 -06/30/2023  Total Amount of Federal Funds Awarded $46,763,580.00  Amount of] Federal Funds Obligated to CDPHE TBD  Federal award title of project or program: Public Health Emergency Preparedness. Ther name of thel Federal awarding agency is: DEPARTMENT OF HEALTH. AND HUMAN SERVICES Centers for Disease Control and Prevention and the contact information for the awarding official is Daniele Ngantou, Public Health. Advisor ywzo@cdc.gov; the name of the pass-through entityi is the State of Colorado, Department of] Public Health and Environment (CDPHE), and the contact information for the CDPHE official is Amanda Hettinger, The Catalog ofl Federal Domestic Assistance (CFDA): number is 93.069 and the grant name is k. Subrecipient is not required toj provide matching funds. Ini the event the Subrecipient is required toj provide matching funds, Section 8 oft this. Attachment applies. Thei indirect cost: rate for thel Federal award (including ifthe de minimis rate is charged per2 2 CFR $200.414 Indirect (F&A) costs) is pre-determined based upon the State of Colorado and  mmaistineraicsois Project Director. Public Health Emergency Preparedness. This award is not for research & development.  CDPHE cost allocation plan.  Pagel lof4  Amendment Contract Number: 2024*0106. Amendment#5  Ver, 25,02,20    DocuSign Envelope ID:  2) Subrecipient shall ata all times during thet term oft this contract strictly adhere tot the requirements under thel Federal Award listed above, and all applicable federal laws, Executive Orders, and implementing 3) Any additional requirements that CDPHE imposes on Subrecipient in order for CDPHE to meet its own responsibility to thel Federal awarding agency, including identification ofany required financial and 5) Subrecipient must] permit CDPHE and auditors tol have açcess to Subrecipient's records and financial statements as necessary for CDPHE to meet the requirements of2 CFR $200.331 Requirements for pass- through entities, SS 200.300 Statutory andl National Policy Requirements through $200.3091 Period of 6) The appropriate terms and conditions concerning closeout oft the subaward are listed in Section 16 of 7) Performance and Final Status. Subrecipient shall submit all financial, performance, and other reports to CDPHE: no later than 45 calendar days after the period of performance end date or sooner termination of this Contract containing an evaluation and review of Subrecipient's performance and the final status of 8) Matching Funds. Subrecipient shall provide matching funds as stated in the Exhibits. Subrecipient shall have raised the full amount of matching funds prior tot thel Effective Date and shall report to CDPHE regarding the status ofs such funds upon request. Subrecipient's obligation to pay all or any part ofany matching funds, whether direct or contingent, only extends toi funds duly and lawfully appropriated fort the purposes ofthis Contract by the authorized representatives of the Subrecipient and paidi into the Subrecipient'st treasury or bank account. Subrecipient represents to CDPHE that the amount designated as matching funds has been legally appropriated for the purposes oft this Contract by its authorized representatives and paidi intoi its treasury or bank account. Subrecipient does not byt this Contract irrevocably pledge present cash reserves for payments ini future fiscal years, and this Contract is not intended to create ai multiple-fiscal year debt of the Subrecipient. Subrecipient shall not! pay or be liable for any claimed interest, late charges, fees, taxes or penalties ofa any nature, except as required by 9) Record Retention Period. The record retention period previously stated in this Contract is replaced 10) Single Audit Requirements. IfSubrecipient expends $750,000 or more: in Federal Awards during Subrecipient's: fiscal year, Subrecipient shall procure or arrange for a single or program-specific audit conducted for that year in accordançe with the provisions of Subpart F-Audit Requirements oft the Uniform Guidance, issued pursuant tot the Single. Audit Act Amendments of 1996,(31U.S.C. 7501-7507). 2CFR 11) Contract Provisions. Subrecipient shall comply with and shall include all oft the following applicable a. Office of Management and] Budget Circulars and' The Common Rule for Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local b. when required by Federal program legislation, the Davis-Bacon Act", as amended (40 U.S.C.3141-3148) as supplemented by Department ofLabor Regulations (29 CFR Part: 5, "Labor Standards Provisions Applicable to Contracts Covering Federally Financed and  regulations as they currently exist and may hereafter be amended.  performance reports, are statedi in the Exhibits.  4) Subrecipient's approved indirect cost rate is as statedi in the Exhibits.  performance, and Subpart F--Audit Requirements of this Part.  this Attachment.  Subrecipient's obligations hereunder.  Subrecipient's laws or policies.  with thei record retention period prescribed in 20 CFR $200.333.  $200.501.  provisions in all subcontracts entered intol by itj pursuant tot this Contract:  Governments, as applicable;  Assisted Construction");  Page2of4  Amendment Contract Number: 2024*0106. Amendment#5  Ver.25,02.20    DocuSign Envelope ID: 330BC97E-A4F0-4F0-4522-B0A3-29694E90A9BF  when required by Federal program legislation, the Copeland' "Anti-Kickback", Act (40 U.S.C. 3145), as supplemented by Department ofLabor regulations (29 CFRI Part 3, "Contractors and Subcontractors on Public Building ofPublic Work Financed in' Whole ori in Part by Loans d. 42 U.S.C. 6101 et seq., 42 U.S.C. 2000d, 29 U.S.C. 794 (regarding discrimination); e. the "Americans with Disabilities Act" (Public Law 101-336; 42 U.S.C. 12101, 12102, 12111 12117, 12131-1 12134, 12141- 12150, 12161-1 12165, 12181-12189, 12201-12213: and4 47 when applicable, the Contractor shall comply with thej provisions oft the "Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local g. Thel Federal Funding Accountability and Transparency. Act of2006 (Public Law 109-282), as amended by $6062 of Public Law 110-252, including without limitation all data reporting requirements required there under. This Acti is also referred to as FFATA. h. Contractor shall comply with the provisions of Section 601 ofTitle VIoft the Civil Rights Act Except as otherwise provided under 41 CFR Part 60, all contracts that meet the definition of "federally assisted construction contract" in 41 CFR Part 60-1.3 comply with the equal opportunity clause provided under 41 CFR 60-1.4(b), in accordance withl Executive Order 11246, "Equal Employment Opportunity: (30 FR 12319, 12935,3 CFR Part, 1964-1965 Comp., p. 339), as amended byl Executive Order 11375, "Amending Executive Orderl 11246 Relating to Equal Employment Opportunity," and implementing regulations at 41 CFR part 60, "Office of] Federal Contract Compliance Programs, Equal Employment Opportunity, where applicable, Contract Work Hours and Safety Standards Act (40 U.S.C. 3701-3708). <. ifthel Federal award meets the definition of"funding agreement" under 37 CFR $ 401.2(a) and the recipient or subrecipient wishes to enteri into an agreement with as small business firm or nonprofit organization, comply with the requirements of37 CFR Part 401, "Rights to Inventions Made by Nonprofit Organizations and Small] Business Firms Under Government Grants, Contracts and Cooperative Agreements," and any implementing regulations issued by the Clean Air Act (42 U.S.C. 7401-7671q.): and thel Federal Water Pollution Control Act (33 m. ifapplicable, comply with the mandatory standards and policies on energy efficiency contained within the State of Colorado's energy conservation plan issued in compliance with n. the Contractor and all principals are not] presently debarred, suspended, proposed: for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal department or agency; the Contractor and all principals shall comply with all applicable regulations pursuant tol Executive Order 12549 (3CFR Part 1986 Comp., p. 189) and Executive Order 12689 (3 CFR. Part 1989 Comp., p. 235), Debarment and Suspension; 0. the Contractor shall comply where applicable, the Byrd Anti-Lobbying Amendment (31  or Grants from the United States").  U.S.C.225 and 47 U.S.C. 611); Governments" (Common Rule);  of 1964, as amended.  Department ofLabor.  the awarding agency. U.S.C. 1251-1387), as amended.  thel Energy Policy and Conservation Act, 42 U.S.C. 6201.  and, U.S.C.1 1352).  Page3of4  Amendment Contract Number: 2024*0106. Amendment#5  Ver, 25,02.20    DocuSign Envelope ID: 330BC97E-A4F0-4F0-4522-B0A3-29694E90A9BF  12) Compliance. Subrecipient shall comply with all applicable provisions ofThe Office of Management and) Budget Uniform Administrative Requirements, Cost Principles, and Audit Requirements forl Federal Awards (Uniform Guidance), including buti not limited to these Supplemental Provisions for Federal Awards. Any revisions to such provisions automatically shall become aj part oft these Supplemental Provisions, without the necessity of either party executing any further instrument. CDPHE may provide written notification to Subrecipient of such revisions, but such notice shall not be a condition precedent to 13) Procurement Procedures. Subrecipient shall usei its own documented procurement procedures which reflect applicable State, local, and' Tribal laws andi regulations, provided that thej procurements conform to applicable Federal law and thes standards identified in the Uniform Guidance, including without limitation, 14) Certifications. Unless prohibited by Federal statutes ori regulations, CDPHE: may require Subrecipient to submit certifications and representations: required byl Federal statutes orI regulations on an annual basis (2CFR $200.208). Submission may be required: more frequently if Subrecipient fails to meet ar requirement oft the Federal award. Subrecipient shall certify in writing to CDPHE at the end of the Contract that the project or activity was completed or thel level ofe effort was expended. 20 CFR $200.201(b)(3). Ifthe required level ofa activity or effort was not carried out, the amount of the Contract 15) Event of Default. Failure to comply with the Uniform Guidance or these Supplemental Provisions for Federal Awards shall constitute an event of default under the Contract pursuant to 2 CFR $200.339 and CDPHE: may terminate the Contract in accordance with thej provisions int the Contract. 16) Close- Out. Subrecipient shall close out this Contract within 45 days after the End] Date. Contract close out entails submission to CDPHE by Subrecipient ofa all documentation defined as a deliverable in this Contract, and Subrecipient's final reimbursement: request. Ifthe project has not been closed by the Federal awarding agency within 1 year and 45 days after the End Date due to Subrecipient's failure to submit required documentation that CDPHE has requested from Subrecipient, then Subrecipient may be prohibited from applying for new. Federal awards through the State until such documentation has been 17) Erroneous Payments. The closeout ofal Federal award does not affect the right of the Federal awarding agency or CDPHE to disallow costs andi recover funds on the basis ofa later audit or other review. Any cost disallowance: recovery is to be made within the record retention period.  the effectiveness of such revisions.  $$200.3181 through 200.3261 thereof.  must be adjusted.  submitted and accepted.  EXHIBIT END  Page4of4  Amendment Contract Number: 2024*0106. Amendment#5  Ver, 25,02.20    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested: 6-13-23  Submitter:  Mark Westhoff, County Administrator  Submitted to the County Administration Office on:  5-22-2023  Return Originals to: Jana Coen  Number of originals to return to Submitter:  1  Contract Due Date:  Item Itle/Recommended Board Action: Championship in both shot and discus throw.  Consider ratifying 5-22-2023 email poll approval of a Letter of Congratulations sent to Mr. John Hainer for 2023 CHSAA Track and Field 1A State  Justification or Background:  Fiscal Impact: This item is budgeted in the following account code:  County: $_ Federal: $_ State: Other:  $_ $    :  Board of County Commissioners  Prowers County 301 South Main, Suite 215 Lamar, Colorado 81052-2857  LORAD THOMAS GRASMICK FIRSTDISTRICT May 23, 2023 Mr. John Hainer 111S. Dugger Ave Bristol, CO 81047  (719)336-8025 RONCOOK SECOND DISTRICT  FAX: (719) 336-2255  WENDY BUXTON-ANDRADE THIRD DISTRICT  RE: 2023 CHSAA Track and Field 1A State Championships  John,  We wish to extend to you our congratulations for winning the 2023 CHSAA Track and Field 1A State Championship in both shot put and discus throw. We understand that your shot put Your championships and state record reflect your hard work, dedication, and commitment to excellence. You are truly a champion and a great ambassador, not only for Granada, but fora all  throw also set a Colorado State record for Class 1A.  of Prowers County. We wish you the very best in all of your future endeavors.  Sincerely,  Board of County Commissioners for Prowers County, Colorado  RorCook, Chair  RA  Vice-Chair  mlphfadud  WendyE Buxton-Andyade,  Rth.  Thomas Grasmick, Commissioner    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested:  6-13-2023  Submitter: Darren Glover, PATS Director Submitted to the County Administration Office on:  5-26-2023  Return Originals to:  Jana Coen & Darren Glover  Number of originals to return to Submitter:  2  Contract Due Date:  ASAP  Item Title/Recommended Board Action:  Consider ratifying 5-26-2023 email poll approval of Lower Arkansas Valley Area Agency on Aging (LAVAAA), Title III-B Older Americans Act Services and State Funding for Senior Services, grant application period July 1, 2023 -. June 30,  2024 for Prowers Area Transit. Justification or Background: Annual Grant Application  Fiscal Impact: This item is budgeted in the following account code:  County: Federal: State: Other:  $_ $_ $ $_  Approved by the County Attorney on:  5-26-2023    APATAThE 1117 2083-2024  PATS  7) layaaa -  ylatowmeeayg Lower Arkansas Valley Area Agency on Aging  ASSURANCE OF COMPLIANCE Title III Older Americans Act Services and/or State Funding for Senior Services July 1, 2023 = June 30, 2024  The applicant agency understands that the following provisions and requirements are part of the official application and contract, and as such, become binding upon the conduct of the project, and understands that failure to comply may result in contract suspension and/or termination. The applicant agency has carefully examined the assurances and assures that during the project year, the applicant agency will comply with all pertinent and prevailing laws, regulations, and ordinances of Federal, state, and local governments, including:  The Older Americans Act (OAA) of 1965, as amended, Pub. L. No. 89-73 and the Older Section 504 of the Rehabilitation Act of 1973, Pub. L. No. 93-112, 87 Stat. 394 (Non- Title VI and VII of the Civil Rights Act of 1964, Pub. L. No. 88-352 Non-discrimination on the basis of race, color, religion, sex, age, handicap, or national origin) Americans with Disabilities Act of 1990 (ADA), 42 U.S.C. 12101 et seq. Health Insurance Portability and Accountability Act of 1996, 42 U.S.C. S 1320d et seq. Colorado Department of Human Services, Aging and Adult Services Division, State Unit All applicable state and local health, fire, safety, building, zoning, and sanitation laws,  Coloradans Act (OCA)CRS S 26-11-100 through 26-11-207 Code of Federal Regulations (CFR), Title 45 Public Welfare  discrimination on the basis of handicap)  and implementing regulations  on Aging (SUA), Policies & Procedures Manual and OAA Volume 10  ordinances, or codes    WORK PERFORMED OUTSIDE THE UNITED STATES OR COLORADO  The agency certifies all work performed under this contract, including any subcontracts, is anticipated to be and will be performed within the United States or Colorado, unless otherwise specified in the description of work. If work under this contract is anticipated to be or will be performed outside the United States or Colorado, the countries and/or states where work will be performed and the reasons it is necessary or advantageous to go outside the United States or Colorado to perform the work are also specified in the description of work as pursuant to RIGHTS IN DATA, DOCUMENTS, AND COMPUTER SOFTWARE OR OTHER All intellectual property including without limitation, databases, software, documents, research, programs and codes, as well as all reports, studies, data, photographs, negatives or other documents, drawings or materials prepared by the agency in performance of its obligations under this contract shall be the exclusive property of LAVAAA. Unless otherwise stated, all such materials shall be delivered to LAVAAA by the agency upon completion, termination, or cancellation of this contract. Agency shall not use, willingly allow or cause to have such materials used for any purpose other than the performance of the agency's obligations under this contract without prior written consent of LAVAAA. All documentation, accompanying the intellectual property or otherwise, shall comply with LAVAAA's requirements which include but is not limited to all documentation being in a paper, human readable format which is useable by one who is reasonably proficient in the given subject  CRS S 24-102-206.  ITELLECTUAL PROPERTY  area.  CONFLICT OF INTEREST  During the term of this contract, the agency shall not engage in any business or personal activities or practices or maintain any relationships which conflict in any way with the agency fully performing its obligations under this contract. Additionally, the agency acknowledges that, in governmental contracting, even the appearance of a conflict of interest is harmful to the interests of LAVAAA. Thus, the agency agrees to refrain from any practices, activities, or relationships which could reasonably be considered to be in conflict with the agency fully performing its obligations to LAVAAA under the terms of this contract, without the prior approval of LAVAAA. In the event that the agency is uncertain whether the appearance of a conflict of interest may reasonably exist, the agency shall submit to LAVAAA a full disclosure statement setting forth the relevant details for LAVAAA's consideration and direction. Failure to promptly submit a disclosure statement or to follow LAVAAA's direction in regard to the  apparent conflict shall be grounds for termination of the contract. RECORDS MAINTENANCE, PERFORMANCE MONITORING & AUDITS  The agency shall maintain a complete file of all records, documents, communications, and other materials that pertain to the operation of the program/project or the delivery of services under this contract. Such files shall be sufficient to properly reflect all direct and indirect costs of labor, materials, equipment, supplies and services, and other costs of whatever nature for which a contract payment was made. These records shall be maintained according to generally accepted accounting principles and shall be easily separable from other agency records. The agency shall protect the confidentiality of all records and other materials containing personally  Revised March 2017  2    identifying information that are maintained in accordance with this contract. Except as provided by law, no information in possession of the agency about any individual constituent shall be disclosed in a form including identifying information without the prior written consent of the person in interest, a minor's parent, guardian, or the State. The agency shall have written policies governing access to, duplication and dissemination of, all such information and advise its agents, if any, with a copy or written explanation of these confidentiality The agency authorizes LAVAAA to perform audits and/or inspections of its records to assure compliance with the contract terms and/or to evaluate the agency's performance. The agency shall permit LAVAAA to monitor all activities conducted by the agency pursuant to the terms of this contract. Monitoring may consist of internal evaluation procedures, reexamination of program data, special analyses, on-site verification, or formal audit examinations. All such monitoring shall be performed in a manner that will not unduly interfere with contract work. Activities conducted under Title III and/or SFSS are subject to audit in accordance with generally accepted auditing standards, including the Single Audit Act of 1984, as amended; the provisions of the United States General Accounting Office (U.S. GAO) "Standards for Audit of Governmental Organizations, Programs, Activities, and Functions" as they pertain to financial and compliances audits; and 2 CFR 200, formerly known as the Office of Management  requirements before access to confidential data is permitted.  and Budget (OMB) Circular A-133 and Government Audit Standards,  CRIMINAL BACKGROUND CHECK  Pursuant to CRS S 27-90-111 and the Department of Human Services (DHS) Policy VI-2.4, any independent contractor, and its agent(s), who is designated by the Executive Director or the Executive Director's designee to be a contracting employee under CRS S 27-90-111, who has direct contact with vulnerable persons in a state-operated facility, or who provides state- funded services that involve direct contact with vulnerable persons in the vulnerable person's home or residence, shall submit to a criminal background check and report any arrests, charges, or summonses for any disqualifying offense as specified by CRS S 27-90-111 to LAVAAA. Any contractor or its agent(s) who does not comply with CRS S 27-90-111 and DHS Policy VI-2.4, may, at the sole discretion of LAVAAA, be suspended or terminated.  PUBLIC CONTRACTS FOR SERVICES  [Not Applicable to agreements relating to the offer, issuance, or sale of securities, investment advisory services or fund management services, sponsored projects, intergovernmental agreements, or information technology services or products and services.] Contractor certifies, warrants, and agrees that it does not knowingly employ or contract with an illegal alien who will perform work under this contract and will confirm the employment eligibility of all employees who are newly hired for employment in the United States to perform work under this contract, through participation in the E-Verify program or the Department program established pursuant to CRS S 8-17.5-101 and CRS 58-17.5-10215)0C). Contractor shall not knowingly employ or contract with an illegal alien to perform work under this contract or enter into a contract with a subcontractor that fails to certify to Contractor that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this  contract.  Revised March 2017  3    HEALTH INSURANCE PORTABILITY & ACCOUNTABILITY ACT OF 1996  Federal law and regulations governing the privacy of certain health information requires a Business Associate Contract between LAVAAA and the agency per 45 CFR Section 164.504(e). Ifa applicable to this contract, attached and incorporated herein by reference and agreed to by the parties is a HIPAA Business Associate Addendum for HIPAA compliance. Terms of the addendum shall be considered binding upon execution of this contract and shall remain in  effect during the term of the contract including any extensions.  PROGRAM & ADMINISTRATION  The agency shall:  Understand that failure to comply with any requirements of the award may result in a suspension and/or termination of the contract pursuant to 45 CFR 74.61. Agree to advise LAVAAA of needed program and financial changes and await approval Understand that if there are Title III and/or SFSS unearned at the time the contract is Understand that this award is made for the period and amounts stated in the contract, subject to the availability of funds, and constitutes a ceiling for Federal/state participation, unless revised. The contract in no way implies further funding which is contingent upon the availability of funds and approval of future project applications. Understand that funding is dependent upon completion of the objectives of the program as outlined in the application for which these funds were originally contracted. Not use Title III or SFSS to pay for fines, penalties, or to replace funds from non- Federal sources; make substantial efforts to obtain support from private sources and Not use Title III or SFSS to duplicate services which may be funded through Medicaid, Medicare, Social Security Act Title XX, or other available Federal, state, or local Agree to maintain adequate insurance coverage, with the State of Colorado named as Additional Insured, which will provide reasonable protection against the risks involved Agree to maintain an inventory of all items and equipment purchased with Title III and/or SFSS and provide such records to LAVAAA upon request. Permission must be obtained from LAVAAA prior to any transfer or disposition of property, equipment, or Forward to LAVAAA for review prior to subcontract negotiations any subcontracts held ori initiated by the agency which involve expenditures to be charged to the Title III Have an applicant advisory board that meets regularly to provide the contract recipient with guidance in the operation of the program. This board will include a substantial Maintain the confidentiality of information relating to specific consumers by: the consumer and is used only for the purpose(s) gathered.  from LAVAAA prior to change implementation. terminated, this amount must be returned to LAVAAA.  other public organizations for services funded by Title III.  sources.  under the activities of the applicable programs,  supplies purchased with Title III and/or SFSS.  and/or SFSS contract.  representation of elderly persons.  Assuring that such information is gathered only with the informed consent of  Revised March 2017  4    Assuring security of records is maintained to prevent unauthorized use. Assure that a waiting list for the services offered under this agreement is developed, maintained, and made readily available for review by LAVAAA and/or SUA. This procedure will be in accordance with the policy of LAVAAA. Ensure that applicants to or consumers of services are advised of their right to complain about services or the denial of services, to appeal decisions made about the complaint, and that those complaints and appeals are processed and tracked Assure agency policy and procedures manual includes local emergency preparedness  according to the policy of LAVAAA.  documentation. ACCOUNTING & REPORTING The agency shall:  Have a financial accounting system(s) adequate to handle the accounting of all income Maintain such accounts and documents as will serve to permit determination at any time of the status of funds within the award, including the disposition of all monies received, and the nature and amount of all charges claimed against such funds Ensure that programmatic and fiscal data are on file and available to LAVAAA including Track expenditures and if needed, develop actions plans to correct deficiencies and Keep records and make reports on the forms prescribed by LAVAAA and in accordance  and expenditures pursuant to 45 CFR 74.21.  pursuant to 45 CFR 74.21.  service expenditures, local cash, in-kind, and program income.  advise LAVAAA in a timely manner of plans. with guidelines issued by SUA:  Agency will submit monthly Request for Reimbursement reports to LAVAAA by the tenth (10th) day (or last working day before the tenth) following the month Agency will submit detailed final financial report within forty-five (45) days after Agency agrees to submit any other reports to LAVAAA as requested. Understand that failure to submit required fiscal reports in a complete, accurate form by the tenth (10th) day following the month reported shall result in no Request for Reimbursement being processed until such time as all reporting requirements have Develop a self-evaluation system which will provide adequate feedback from the recipients of services, the results of which must be made available upon request to Agree to request technical assistance from LAVAAA as necessary and provide training and technical assistance to staff and providers regarding data entry methods.  reported on forms prescribed by LAVAAA. the end of the project year.  been met.  LAVAAA for planning and evaluation purposes.  MATCHING The agency shall:  Agree to provide local match in the required amounts and to sustain a local  Revised March 2017  5    maintenance of effort in the amounts and percentages required by the contract. If the actual costs vary from the amounts specified, the local share will not be less than the  required cost sharing percentages:  SFSS: 10% (1/9th of the total allocation) Title III Part B, C: 10% (1/9th of the total allocation) Title III Part E: 25% (1/3rd of the total allocation)  Maintain documentation to support all in-kind and/or local cash match and provide documentation in order to permit determination at any time of the status of that Not use the local cash and/ori in-kind match for a Title III and/or SFSS contract to fulfill Ensure that cash and/or in-kind match contributed shall not consist of Federal funds Understand that Title III and/or SFSS cannot be used to reimburse costs generated by  contribution.  matching requirements for other Federal funds.  org general program income, except as provided in 45 CFR74.23.  in-kind contributions. VOLUNTARY CONTRIBUTIONS consumer. The agency shall:  Agency will ensure that consumers' voluntary contributions are handled and safeguarded according to LAVAAA policy and are responsibly collected while ensuring the anonymity of the  With regard to participants:  Provide participants receiving service(s) the free and voluntary opportunity to contribute to all or part of the cost(s) of the service(s) provided. Protect the privacy of each participant with respect to his or her contribution(s). Allow each participant to determine for him/herself if/what he/she is able to contribute toward the cost(s) of service(s). No participant shall be denied service(s) or limited service(s) because of not contributing to the cost(s) of Establish appropriate procedures to safeguard and account for all contributions. Use all contributions to expand the services of the Title III and/or SFSS Handle all contributions received from participants in such a manner sO as not Account for income received from contributions according to one of the authorized methods described in 45 CFR 74.24, consistent with regulations  service(s). With regard to contributions:  contract.  to differentiate among individual contributions publicly.  governing program income.  Adhere to the following minimum standards:  All employees and volunteers designated to handle contributions shall Contributions collected for each project shall be counted by two (2) designated employees or volunteers who will certify the amount.  be bonded.  Revised March 2017  6    A form shall be designed by each project to account for the daily collections at each project site. The form shall provide, at a minimum: the date and name of the site; the total amount collected; the signatures of the two (2) individuals counting the money and certifying the amount collected; and if the monies are transmitted to the central office, the signature of the employee who received the site collections on behalf of the central office. The completed collection forms shall be kept on file at the central office for audit purposes. The amount collected as recorded on the collection form shall be compared with the corresponding bank deposit with the amount of any shortage or overage noted on the collection form and initialed by the Project Director. An explanation or comment on any discrepancy of  more than ten (10) dollars shall also be provided.  INFORMATION & ASSISTANCE  All recipients of Title III and/or SFSS shall provide for Information & Assistance Services sufficient to ensure that all older adults within the service area have reasonable, convenient access to information concerning services, benefits, and opportunities. This program includes one-on-one or group contacts between the information and assistance provider and  consumer and/or caregiver. The agency shall:  Evaluate the needs and capacities of consumers.  Develop and maintain current information about opportunities, benefits, services, and resources available to consumers within the community and provide those to the Refer consumers to needed services, including initiating an arrangement between the consumer or caregiver and the service provider, if necessary, and advocating with Where practical, follow up to ensure that the consumer and/or caregiver have been Provide additional assistance to the consumer and/or caregiver in locating or Employ, where feasible, specially trained staff to assess the needs of older adults and inform older adults of the opportunities and services which are available and In areas where five (5) percent or more of consumers speak a language other than English as their principal language, provide information and assistance in that  consumer and/or caregiver.  agencies on the behalf of consumers. able to access the services available. accessing needed services, if necessary.  assist older adults to utilize the opportunities and services.  language.  TARGETING The agency shall:  Advertise the availability of services to elderly persons, families of elderly persons, and service providers via posters, multi-purpose senior centers, free to low-cost public service announcements on radio or television, newspaper advertisements, and listings  in local resource directories.  Seek to serve eligible consumers, with particular attention to:  Revised March 2017  7    Older individuals with greatest social need. Older individuals with greatest economic need. Older individuals at risk for institutional placement. Low income minority individuals. Older individuals with limited English proficiency. Older individuals residing in rural areas.  Comply with all procedures which may be developed by LAVAAA regarding: Training and use of elderly and other volunteers and paid personnel. Coordination with other service providers in Region 6. Information and Referral activities to ensure the reasonable, convenient access to information concerning services, benefits, and opportunities.  OUTREACH  Outreach efforts shall have special emphasis on reaching those with greatest economic or social needs, with particular attention to low income minority individuals in at least the same proportion as the population of low income minority individuals bears to the population of older adults. This program includes interventions with consumers and/or caregivers for the purpose of identifying potential consumers and encouraging the consumer and/or caregivers' use of existing services and benefits. The agency shall:  Conduct outreach activities throughout the Plan Service Area (PSA) to identify Establish communication with the local news media to inform the public of available services and opportunities to contribute to the planning and implementation of Establish linkages with information and referral programs within the service area to ensure that consumers have access to information about available services and Inareas where five (5) percent or more of consumers speak a language other than English as their principal language, provide outreach, information, and assistance  consumers and their caregivers. services for seniors. opportunities.  services in that language. CAREGIVER SERVICES  Caregiver services shall meet the requirements described in OAA Volume 10. These services shall include, but are not limited to, information, access assistance, respite, counseling, and supplemental services, such as medical equipment, offered to caregivers of consumers and  grandparents raising children under the age of eighteen.  LEGAL SERVICES  This program is established to offer advice, counsel, and legal intervention for eligible consumers regarding issues such as public benefits, health care, financial exploitation, consumer problems, advanced directives, and guardianship. Older adults often experience issues that threaten their autonomy, dignity, rights, and security; and for some consumers  these issues require legal intervention. The agency shall:  Revised March 2017  8    Comply with the standards described in the Colorado Legal Assistance Policies and Procedures Manual (Statewide Standards for Title IIIB Legal Assistance in Colorado) Work cooperatively and appropriately to resolve any issues noted by the Colorado Legal Assistance Developer (CLAD), e.g. during the CLAD's onsite evaluation. The CLAD operates under contract with the State to provide oversight, technical assistance and consultation for the local legal assistance providers.  and OAA Volume 10.  TRANSPORTATION SERVICES in the community. The agency shall:  The agency shall make transportation and assisted transportation available to consumers for the purpose of accessing, services necessary to remain independent and socially integrated  Not use Title III and/or SFSS to pay for transportation or assisted transportation if such transportation is offered or covered through other Federal or state programs for Have all necessary licenses, approvals, or certifications required by Federal, state, Be licensed by the Public Utilities Commission (PUC) and assure that their drivers, vehicles, and auxiliary equipment meet all applicable regulations and standards for passenger and vehicle safety, maintenance requirements, and minimum insurance  which the consumer may be eligible. and local law or regulation.  coverage. NUTRITION SERVICES  The agency shall provide an array of nutrition services, including nutrition education, screening, assessment, and counseling; therapeutic meals; medical foods as feasible and appropriate; and meal preparation and delivery to senior centers, dining centers, nutrition sites, and consumer residences. The program promotes and emphasizes comprehensive preventive approaches utilizing community nutrition services to maintain the health and  independence of consumers. The agency shall:  When prescribed as necessary to treat a diagnosed medical condition, provide or make referrals to resources for medical nutritional food as a meal replacement. Contract with a registered dietitian to approve menu nutrient content compliance, approve nutrition education materials, and provide nutrition counseling. Coordinate consultations between the registered dietitian and the Nutrition Director or dietetic technician registered to determine feasibility and appropriateness of modified diets and medical nutritional foods, monitor method of nutrient analysis, monitor referrals to internal and external nutrition resources, review food safety and sanitation monitoring, and review food service operations training. Provide information and assistance about the Supplemental Nutrition Assistance Program (SNAP) to consumers who may be eligible for such benefits and inform Provide home delivered meal services to older adults with an emphasis on those of greatest social or economic need, with particular attention to low income minority consumers and consumers residing in geographically isolated areas. Perform initial assessment and homebound status assessment every six months to ensure or determine eligibility and provide home delivered meals only to consumers  consumers if the nutrition program accepts SNAP.  Revised March 2017  9    determined to be homebound or geographically isolated.  Provide meals that:  Comply with the Dietary Guidelines for Americans, published by the Secretary of Health and Human Services and the Secretary of Agriculture. Provide each participating consumer a minimum of 33 1/3 percent of the medically recognized daily recommended dietary allowances or references for dietary intake if only one meal per day is provided; or 66 2/3 percent of the allowances if two (2) meals per day are provided; or 100 percent of the Are adjusted, as feasible and appropriate, to the maximum extent practical to meet any special dietary needs of program consumers including, special Have been specially modified and approved by a registered dietitian to meet therapeutic, religious, or ethnic requirements as feasible and appropriate, but Ensure OAA meals meet the 33 1/3 percent DRI standard from the most current release from the Food and Nutrition Board of the Institute of Medicine of the National Academy of Sciences. These quantifiable reference values of nutrients are used in the nutrition program to maintain nutritional adequacy, promote health, and reduce risk of disease. Nutrition program menus shall comply with the Dietary Guidelines for Americans, published from the United States Department of Health and Human Services and the United States Maintain and make available for review an approved copy of the menu cycles and analyses on file at the nutrition site(s), and available for review by Analyze menus and recipes using a nutrient analysis software package to ensure compliance with the Dietary Guidelines for Americans, Recommended Dietary Allowances, and Dietary Reference Intakes, and have them approved Use only tested quality recipes, adjusted to yield the number of servings. Document substitutions or deviations from the approved menu(s). Maintain menu cycles and nutrient analysis for a minimum of three (3) years for audit purposes unless disposition is authorized by SUA.  allowances if three (3) meals per day are provided. health, religious, or ethnic requirements.  may not meet the minimum dietary requirements.  With regard to Menu Cycles and Analysis:  Department of Agriculture. LAVAAA or SUA at any time.  by a registered dietitian.  Revised March 2017  10    NARRATIVE TITLEIIIB  SECTION 1: Project Direction: Prowers County covers 1,638 square miles with 6 communities (Wiley, Lamar, Bristol, Hartman, Granada and Holly). Prowers County population is 11,854. This is using the 2022 Census estimated information. Title IIIB funding helps provide transportation services for the senior citizens of Prowers County. Prowers Area Transit provides Transit services for the residents of Prowers County. Prowers Area Transit targets senior citizens, low-income and handicapped individuals but are available to the general public. PATS bring senior citizens to the Lamar Community Resource and Senior Center' Wednesday through Friday forr nutritional meals provided by SAGE Services. Senior Citizens can call dispatch for reservations up to 30 days in advance for all rides. This gives the senior citizens of Prowers County freedom' in making their own decisions on when and where they go and not having to 'bother' family and friends for rides. Many of our Senior Citizens no longer have family and friends int the area to depend on. With PATS, this gives the county's senior citizen the ability to stay in their own homes longer by providing them with the ability to do SO. In 2022, Prowers Area Transit provided 3,395 rides to senior citizens in Prowers County. As of May 22, 2023, Prowers Area Transit has provided 1,223 rides for the senior citizens of Prowers County. With the end of the pandemic, we are seeing our ridership increasing as the residents are feeling safer utilizing Public Transit. Prowers Area Transit coordinates with the Lamar Senior Citizens Inc., Prowers County Department of Human Services, City of Lamar, Prowers County and several local senior organizations on the best way to provide transit services to Prowers County Senior Citizens. Prowers Area Transit is the best suited to provide transit services to the: senior citizens of Prowers County due to the fact that there are no other transit services SECTION 2: Project Plan: In the grant cycle of 2023-2024, Prowers Area Transit will have the following as priorities: 1. Maintaining the current number of Senior Citizens that ride our transit, Continuing the healthy environment of the Transit vehicles. 2. Increasing the registrations for Senior Citizens. 3. SECTION 3: Outcomes: Our outcomes for Prowers Area Transit: 1. Increase the services and resources for the Senior Citizens that utilize the transit services (to access information: and/ori transit to medical nutritional, mploymenyeducation and: shopping sites). 2. Increase registrations for the Senior Citizens and the registrations for the individuals (senior citizens) who utilize the transit services. SECTION 4: Information and Assistance Services: Prowers Area Transit provides necessary information tot the citizens of Prowers County (i.e. Senior Citizens) through brochures, Public service announcements  in Prowers County.  Increasing and/or maintaining the level of service to our Senior Citizens.  in the local newspaper: and radio stations.  Section 5: Targeting: PATS ensure that the citizens (i.e. Senior Citizens, low-income, handicapped and general public) of Prowers County are informed of all services and resources available to them through our organization. We evaluate our services with a survey every year in. June (i.e. passenger and senior citizen survey). Then these surveys are evaluated and if needed, the services are corrected and/or    increased. For the citizens with LEP (Limited English Proficiency), translators are available for our  passengers in Prowers Area Transit.  SECTION 6: Outreach Services: Prowers Area Transit keeps the citizens (i.e. Senior Citizens, Low- Income, Handicapped and General Public) of Prowers County informed of the services provided by PATS. This is done by our public service ads in the local newspapers, Local radio stations and Local cable TV station. PATS distributes its brochures at all senior housing areas in Prowers County also at the Department of Human Services (Options for Long Term Care). We also keep brochures for PATS and we provide them to the Lamar Community Resource and Senior Center. Coordination between the Senior Center, Lamar Senior Citizens, Inc., Prowers County Department of Human Services, Prowers County and the City of Lamari is a musti in our Outreach Program. With the annual passenger/senior citizen survey, Prowers Area Transit can evaluate the effectiveness of our outreach services to our residents (i.e. Senior SECTION 7: Additional Information: Prowers Area Transit has received funding from LAVAAA since the early 2000's. In the last 10 years, we have received funding from the high of (Title IIIB Transportation)- - inz 2019 ofs $12,765.00. The Low's were as follows (Title IIB) in transportation of: in 2018 of $4,967.00. There has been several years that PATS did not fully expend our awarded funds. The reasons behind this isa as follows: Several years we did not have enough eligible expenses to submit for reimbursement. Also in 2019/2020 and 2020/2021 grant cycles we had greatly reduced ridership due to the pandemic.  Citizens, Handicapped Individuals and Low-Income) of Prowers County.    B  S 5 5 3 S  2  S  S  3  S  6 3 2  S  5  -  S  5    N W 4  3  A E 9  s 3    lavaaa -  advocacylaction lanswersonaging Lower Arkansas Valley Area Agency on Aging  REQUEST FOR PROPOSALS Title III Older Americans Act Services and/or State Funding for Senior Services  The Lower Arkansas Valley Area Agency on Aging (LAVAAA) is requesting proposals from qualified organizations interested in receiving a grant funded under the Older Americans Act to provide services to seniors age 60 and older in Region 6, which includes Baca, Bent, Crowley, Kiowa, Otero, and Prowers Counties. Qualified organizations include nonprofits, for-profits, public agencies, and private incorporated organizations. Funding is available for nutrition, chore, homemaker, personal care, transportation, caregiver support, legal, senior center, and disease prevention and health promotion services. Contracts for this period will The precise level of funding is unknown at this time and will not be known until an official appropriation is made. All funding is subject to revision following award of funds in accordance with final congressional and state legislative appropriations. Funding for the initial plan will be based on State Fiscal Year 2023 funding estimated at $655,440,  be effective from July 1, 2023 through June 30, 2024.  appropriated into five categories:  Title III-B: $90,972 for transportation, legal, in-home, and senior center services Title III-D: $5,906 for evidence-based disease prevention and health promotion State Funds for Senior Services: $332,842 for a variety of senior services Service specifications and a proposal guide may be obtained at the office of the Lower Arkansas Valley Area Agency on Aging, 13 W. 3rd Street, Rm. 110, La Junta, CO 81050. Proposal guides will be mailed upon request. Completed proposals should be mailed or delivered to LAVAAA by 5:00pm, Monday, May 22, 2023, Applicants may contact Jim Collins at (719) 383-4844 or m.colinsestate.co.us with any questions regarding this Applications, if accepted for funding, will be included as part of the contract between LAVAAA and the applicant agency. All objectives in the application will be reviewed as part of the monitoring and evaluation function of LAVAAA. LAVAAA reserves the right to award all, none,  Title III-C: $188715 for nutrition services Title III-E: $37,005 for caregiver support services  request for proposals.  or a portion of funds to one or more applicants.    PROPOSAL INSTRUCTIONS  To be considered, all applications must correctly follow the instructions below and include all sections listed. A complete application must be submitted for EACH service type. If multiple funding sources (e.g. III-B and State Funds) are requested for ONE service, additional Submittal Pages, Services Worksheets, and Budget Worksheets must be completed for EACH corresponding funding part requested. Applications that do not include all sections below will not be accepted. Completed proposals should be mailed or delivered to LAVAAA, 13 W. 3rd Street, Rm. 110, La Junta, CO 81050, by 5:00pm, Monday, May 22, 2023.  Submittal Page  This is the project plan's cover page (page 6 of this packet). The applicant agency is the agency assuming legal and financial responsibility and accountability for the use and disposition of any funds awarded on the basis of this application. The project director is the person who has ultimate staff responsibility for the direction of the project for which support is being sought. If your service area includes multiple counties, please provide an approximate percentage of services in each county (e.g. County 1 (15%), County 2 (85%).  Statement of Intent & Acknowledgment of Assurance of Compliance  This is the transmittal form for the project plan and acknowledgment of administrative requirements set forth in the Assurance of Compliance document (page 7 of this packet). Do not return copies of the Assurance of Compliance document with the application. Applications  will not be accepted without the required signatures.  Narrative  This section describes the overall project plan. Each section should be clearly identified; please  be detailed and descriptive when completing each section.  SECTION 1: Project Direction Include the following:  Describe the overall direction to be taken by the applicant agency toward the development of a comprehensive, coordinated system of services for older adults in the area to be served.  Identify the geographic area to be served by the project Describe the system to be utilized to provide the service(s)  Identify the service(s) to be provided  Describe coordination among the applicant agency and other agencies to ensure the Describe why the applicant agency is best suited to provide the service(s)  best delivery of services  SECTION 2: Project Plan  Clearly identify priorities for this planning cycle in order of importance. List goals to be addressed during the planning period. These goals should relate directly to the priorities established for the service area. The plan should include a summary of expected outcomes at    the end of the plan period and serve as a performance evaluation tool throughout the next year. Specific objectives and action steps including completion dates must be included.  SECTION 3: Outcomes  Please describe anticipated project outcomes to demonstrate how the applicant agency's service(s) address the needs of older adults. Plans should concentrate less on data regarding the amount of service and more on information regarding the impact of the service on individual clients. While we will still track how many clients are served, reporting should also  address: Core Outcomes  economic self sufficiency family and community connections health and rehabilitation independent living safety Intervening Outcomes  access to basic living needs efficient provision of quality services non-duplication of services  least restrictive environment, maximum independence  SECTION 4; Information and Assistance Services  Information and Assistance (I&A) Services shall be developed sufficient to ensure all older adults within the service area have reasonable, convenient access to information concerning services, benefits, and opportunities. In an area in which five (5) percent or more of the older adults speak a language other than English as their principal language, the I&A services must The applicant agency's system for delivering I&A Services in the service area How the applicant agency will maintain current information with respect to the How the applicant agency will refer older adults to needed services using current lists of opportunities, benefits, and services for older persons, and provide follow-up as How the applicant agency will employ, where feasible, a specially trained staff to assess the needs of older persons and to inform older persons of the opportunities and services which are available and assist older persons to utilize the opportunities and  be provided in that language. Please describe:  Methods used to evaluate effectiveness of I&A Services opportunities, benefits, and services available to older persons  necessary  services  SECTION 5: Targeting  Describe the methods and steps to be used to ensure services are targeted to those individuals who are soclaly/economicaly disadvantaged, minorities, and/or rural. Specifically describe the targeting methods that will be used to increase the level of service provision and the techniques that will be utilized to evaluate the effectiveness of the targeting plan.    SECTION 6: Outreach Services  Outreach efforts shall have special emphasis on reaching those individuals who are socaly/economicaly disadvantaged, minorities, and/or rural. In an area in which five (5) percent or more of the older adults speak a language other than English as their principal language, Outreach Services must be provided in that language. Please describe: The applicant agency's system for delivering Outreach Services in the service area to identify older adults and to inform them of the availability of services Methods used to evaluate effectiveness of Outreach Services How the applicant agency will seek and identify potential new clients and provide How the applicant agency will establish linkages with information and referral programs within the service area to ensure clients have access to information about  follow-up as necessary  available services and opportunities  SECTION 7: Additional Information  Please indicate the number of years the applicant agency has received funding from LAVAAA and the highest and lowest amounts received. If the applicant agency has in the past been unable to fully expend all awarded funds before the end of the state fiscal year, please provide an explanation and the applicant agency's plan to address this for the upcoming  state fiscal year.    Budget Worksheet  Information included on the applicant agency's budget should refer to projects funded by Title III and/or SFSS only. When completing this worksheet, choose the worksheet tab (located at the bottom) for the funding part that corresponds to the services for which your agency is applying. Applicants may complete ONE worksheet (Title III- ) for their entire budget, and will be automatically considered for both Federal and State (SFSS) funding. Please contact LAVAAA if you are interested in providing services not listed on the worksheets.  Budget Funding  Requested Title III and/or SFSS  Enter the total amount of Title III and SFSS requested for the project. (You will see the amount required for Local Cash or In-Kind Match in the "Local Cash and/or In Kind Match Calculator" section at bottom of the worksheet.)  Enter the total amount of funds from non-Federal third parties used for project related costs. Applicants are required to provide a 10% or 25% Local Cash OR Enter the total value of non-cash contributions from non-Federal third parties used for project related costs. This may include contributed services, space rented, or equipment used to support the project. Applicants are required to provide a 10% or 25% Local Cash OR In-Kind match depending on funding Enter the total amount of consumer contributions expected which will be used tos support the project. Applicants are required to provide opportunities for participating consumers to make voluntary and anonymous contributions toward the costs of services; applicants may not charge fees for services.  Local Cash Match  In-Kind match depending upon funding source requested.  In-Kind Match  source requested. Program Income  Budget Expenses Personnel Travel  Enter salaries, wages, and fringe benefits for employees to be charged to the project. This may include administrative and/or direct service staff. o Enter expenses related to service delivery. Includes mileage reimbursement, hotel charges, meals, and other allowable expenses incurred by employees and Enter expenses related to equipment purchases. Includes tangible property with a useful life of more than one year and an acquisition cost of $500 or more Enter any costs other than those defined above. Includes supplies, postage, and printing. Prior approval is required for any capital expenditures, such as the acquisition of facilities and/or the cost of repairs which materially increase  volunteers for project purposes.  Equipment  per unit. Prior approval is required for all purchases.  Other Costs  the useful life of the capital asset.    Services Worksheet  This worksheet identifies costs by funding source, units of service provided, and characteristics of clients served by service category. Information on this worksheet is used for contract reimbursement and performance monitoring. When completing this worksheet, choose the worksheet tab (located at the bottom) for the funding part that corresponds to the services for which your agency is applying. Applicants may complete ONE worksheet (Title III- ) for their entire budget, and will be automatically considered for both Federal and State (SFSS) funding. Please contact LAVAAA if you are interested in providing services not  listed on the worksheets. Costs by Funding Source  Enter requested Federal and/or SFSS, required project match, projected client contributions,  and all other funds. All funding sources will total under Total Budget.  Unit Cost  Enter the unit cost for each service provided. Refer to the document "Service Definitions and Entry into SAMS" for detailed service descriptions and units associated with each.  Total Units of Service  Enter the total number of units of service for each service provided under this project.  Unduplicated Registered Persons project and any identifying characteristics.  Enter the total number of unduplicated persons age 60 and older to be served under this  Rural: Residing in an area that is not urbanized and has less than 2,500 inhabitants according to the State Demographer's Office. Urban residents include those living Minority; American Indian/Alaskan Native, Asian/Paclicislander, Black not of Hispanlc Low Income Minority: Having an income at or below the FPL AND a minority Disabled: Having a chronic disability attributable to mental and/or physical impairment, or a combination of impairments that is likely to continue indefinitely and results in substantial functional limitation in three or more of major life activities Other: Registered consumers age 60 and older that do not fall into any of the  within the city limits of La Junta, Rocky Ford, or Lamar. Low Income: Having an income at or below the Federal Poverty Level  origin, or Hispanic  categories listed above    Title III Older Americans Act Services and/or State Funding for Senior Services Lower Arkansas Valley Area Agency on Aging July 1, 2023 - June 30, 2024  Applicant Agency Service Area  Prowers Area Transit Prowers County  Services to be Provided  Transportation Services  Funding Type Requested Title IIIB  Project Director Address  Darren Glover  200 East Hickory Street Lamar, Colorado 81052  Telephone and Fax  719-336-8039 Fax-719-336-8018 gloveroprowerscounty.net Local government  Email  Type of Agency    Statement of Intent  &A ACknowiedgment of Assurance of Compliance  This project plan is submitted for the period July 1, 2023 - June 30, 2024. The applicant agency identified will assume full responsibility to develop and administer the annual plan in accordance with the requirements of the Older Americans Act and related State Unit on Aging The applicant agency confirms it has received and understands the administrative requirements set forth in the Assurance of Compliance with the Lower Arkansas Valley Area It is understood and agreed by the applicant agency that: (1) Funds contracted as a result of this request are to be expended for the purposes set forth herein and in accordance with all applicable laws, regulations, policies, and in accordance with the State of Colorado and the Administration on Aging of the US Department of Health and Human Services; (2) Any proposed changes to this proposal as approved will be submitted in writing by the applicant agency and upon notification of approval by the Lower Arkansas Valley Area Agency on Aging shall become a part of this agreement; and (3) Funds awarded as a result of this application may be terminated at any time for violation of any terms and requirements of this agreement and that applicants may be asked to accept a contract for a reduced amount of services with a proportional reduction in grant award dependent on total Federal and state funds available  Policies & Procedures. Agency on Aging.  and passed through the Lower Arkansas Valley Area Agency on Aging.  Prowers County Service Area  Prowers Area Transit Applicant Agency Darren Glover  5-22-2023 Date 5-22-2023 Date 5-22-2023 Date  Printed Name, Project Director Ron Cook, Chairman, BOCC Printed Name, Authorized Official Ron Cook, Chairman BOCC Printed Name, Project Advisory Board  Signature   Signature  k  Signature  lk    PROWERS COUNTY  AGENDA ITEM REQUEST FORM  Hearing Date Requested: 6-13-2023 Submitter: Meagan Hillman, PCPHE Director  Submitted to the County Administration Office on: 05/22/2023 Return Originals to: Meagan Hillman PCPHE Director Number of originals to return to Submitter: 2  Contract Due Date: June 30  Item Tite/Recommended Board Action:  Consider approval ofURHN Contract Amendment No. 1,2023*0329, original Contract No. 2023*0329, funding in the amount of$199,994, term of7-1-2023 to 6-30-2024, and authorizing Meagan Hillman, Public Health Director to execute the document electronically.  Justification or Background: This is annual award for URHN, the grant that funds Prowers  County Youth Council.  Fiscal Impact: Thisi item is budgeted in the following account code:  County: $  Federal: $  State: $  Other: $  Approved by the County Attorney on: Additional Approvals (ifr required):    DocuSign Envelope ID: 7ACBA5D7-BBBE-4F50-80E7-77BAB1819C97  CONTRACT AMENDMENT: #1 SIGNATURE AND COVER PAGE(S)  State Agency: PSD/BHA/URHN 4300 Cherry Creek Drive South Denver, Colorado 80246 Contractor:  Original Contract Number: 2023*0329  Colorado Department OfF Public Health and Environment  Amendment Contract Number: 2023*0329 Amendment: #1  Board of County Commissioners of] Prowers County (a political subdivision of the state of Colorado) 301 South Main Street, #215 Lamar CO 81052 for the use and benefit ofthe Prowers County Public Health 1001 South Main Street Lamar C081052-3838 Contract Performance Beginning Date: July 1,2022  Current Contract Expiration Date: June: 30, 2024  CONTRACT MAXIMUM AMOUNTTABLE  Federal Funding Amount $199,994.00  Document Type Original Contract  Contract Number 2023*0329 2023*0329  State Funding Other Funding Amount $0.00 $0.00  Amount $0.00 $0.00  Term (dates) 7/1/2022- 6/30/2023 7/1/2023- 6/30/2024 Current Contract Maximum Cumulative Amount  Total $199,994.00 $199,994.00 $399,988.00  Amendment #1 Amendment #1 $199,994.00  Page 1of4  Amendment Contract Number: 2023*0329 Amendment: #1  Ver01.11.19    DocuSign Envelope ID:  SIGNATURE PAGE  THE PARTIES HERETO HAVE EXECUTED THIS AMENDMENT  Eachj person signing this Amendment represents andy warrants that he or shei is duly authorized to execute this Amendment political subdivision of thes state ofColorado): for the use Colorado Department of Public Health andl Environment  and tol bind the Party authorizing his or hers signature.  CONTRACTOR  STATE OF COLORADO Jared S. Polis, Governor Jilll Hunsaker Ryan, MPH, Executive Director  Board ofCounty Commissioners ofl Prowers County (a and benefit oft thel Prowers County Public Health  By: Signature  By: Signature  Meagan L Hillman Director  Name of Executive Director Delegate Title of Executive Director Delegate  Name of Person Signing for Contractor Title of Person Signing for Contractor  Date:  Date:  Ina accordance with $24-30-202 C.R.S., this Contract ist not valid until signed and dated below by the State Controller or  an authorized delegate. STATE CONTROLLER Robert Jaros, CPA, MBA, JD  By: Signature  Name of State Controller Delegate Title of State Controller Delegate  Amendment Effective Date:  Signature and Cover Pages End -  Page2of4  Amendment Contract Number: 2023*0329. Amendment #1  Ver. 06.05.20    DocuSign Envelope ID: 7ACBA5D7-BBBE-4F50-80E7-77BAB1819C97  PARTIES State. 2. TERMINOLOGY  This Amendment (the "Amendment") to the Original Contract shown on the Signature and Cover Page for this Amendment (the "Contract") is entered into by and between the Contractor, and the  Except as specifically modified by this Amendment, all terms used in this Amendment that are defined in the Contract shall be construed. and interpreted in accordance with the Contract.  3. AMENDMENT EFFECTIVE DATE. AND TERM  A. Amendment Effective Date  This Amendment shall not be valid or enforceable until the Amendment Effective Date shown under the State Controller Signature. The State shall not bel bound by any provision of this Amendment before that Amendment Effective Date, and: shall have no obligation toj pay Contractor for any Work performed or expense incurred under this Amendment either before The Parties' respective performances under this Amendment and the changes to the Contract contained herein shall commence on the Amendment Effective Date shown under the State Controller Signature or July 1, 2023, whichever is later, and shall terminate on the  or after oft the Amendment term shown in $3.B ofthis Amendment.  B. Amendment Term  termination of the Contract or June: 30, 2024, whichever is earlier.  PURPOSE  The Parties entered into the agreement to reduce substance misuse and abuse among under The Parties now desire to renew for an additional term and change current Contract Maximum Total for the following reason: to add funds to support the renewal term and to update the  resourced high need communities.  project'sa activities in the Statement of Work for the new term.  5. MODIFICATIONS  The Contract and all prior amendments thereto, ifany, are modified as follows:  A. The Contract Maximum Amount table is deleted and replaced with the Current Contract Maximum Amount table shown on the Signature and Cover Page for this Amendment. B. The Contract Initial Contract Expiration Date on the Contract's Signature and Cover Page is hereby deleted and replaced with the Current Contract Expiration Date shown on the C. The Parties now agree to modify Exhibit B., Statement of Work. Exhibit B., Statement of Work., is deleted and replaced ini its entirety with Exhibit B., Statement of Work., attached  Signature and Cover Page for this Amendment.  Page3of4  Amendment Contract Number: 2023*0329. Amendment #1  Ver27.01.20    DocuSign Envelope ID:  to this Amendment, for the following reason: To modify deliverables and performance D. The Parties now agree to modify Exhibit C., Budget, oft the agreement. Exhibit C., Budget, is deleted and replaced in its entirety with Exhibit C., Budget, attached to this Amendment E. The Parties now agree to add Exhibit F, Federal Provisions, for the following reason: To  outcome measures to the SOW: for the renewal term. for the following reason: To add funds for FY24 renewal. add federal award identification information. LIMITS OF EFFECT AND ORDER OF PRECEDENCE  This Amendment is incorporated by reference into the Contract, and the Contract and all prior amendments or other modifications to the Contract, ifany, remain in full force and effect except as specifically modified in this Amendment. Except for the Special Provisions contained in the Contract, in the event of any conflict, inconsistency, variance, or contradiction between the provisions ofthis Amendment and any oft the provisions ofthe Contract or any prior modification tot the Contract, the provisions of this Amendment shall in all respects supersede, govern, and control. The provisions of this Amendment shall only supersede, govern, and control over the Special Provisions contained in the Contract to the extent that this Amendment specifically  modifies those Special Provisions.  Page 4of4  Amendment Contract Number: 2023*0329, Amendment #1  Ver27.01.20    DocuSign Envelope ID: 7ACBA5D7-BBBE-4F50-80E7-77BAB1819C97  EXHIBITB  Statement ofWork  Evidence-Based Prevention Programs & Policies (EBPs) and Under Resourced High Need (URHN) Communities  These provisions are to be read and interpreted in conjunction with thej provisions of the contract  specified above. Article 1  Purpose and' Target Population  1.1 Purpose. The purpose oft this Contract is to continue primary prevention services for the five-year Primary Prevention funding cycle Substance Abuse Prevention and Treatment Block Grant (SABG) that is aligned with federal and state prevention priorities based on the statewide needs assessment and the statewide strategic plan. The SABG guidelines include Primary Prevention activities that are directed at individuals who do not require treatment for a Substance Use Disorder. To facilitate this undertaking, the Substance Abuse and Mental Health Services Administration (SAMHSA) developed the Strategic Prevention Framework (SPF), aj planning approach that is utilized to prevent and address substance abuse and misuse The Department has identified three areas for SABG-funded Primary Prevention programs, a. Preventing and reducing alcohol, marijuana, prescription drugs, and other drug use b. Changing community policies and norms regarding alcohol, marijuana, prescription . - Addressing population-based needs regarding alcohol, marijuana, prescription drugs,  and related behavioral health concerns.  policies, and strategies:  for those under 18 years ofage (tobacco excluded). drugs, and other drug use (tobacco excluded). and other drug use (tobacco excluded).  The Contractor shall continue to develop and implement a Comprehensive Primary Prevention initiative that employs Evidence-Based Prevention Programs and Policies, which include strategies directed att the following populations: children, youth, young adults, and/or families. Implementing evidence-based primary prevention programs and policies will assist the Department in meeting state-level outcomes, such as reductions in substance use, increased attendance at school, decreases in substance-related arrests, increased family communication around substance use, increases in youth exposure toj prevention messaging, and ai reduction in Adverse Childhood Experiences (ACEs). The State goal is to havea significant impact on the identified state level outcomes by funding Primary Prevention programs, policies, and strategies to address substance abuse and misuse.  Page I of16  Amendment Contract) Number: 2023*0329. Amendment; #1    DocuSign Envelope ID: 7AC8A5D7-BBBE-4F50-80E7-77BAB1819C97  EXHIBITB  1.27 Target Population. The Contractor shall continue to develop or maintain and implement a Comprehensive Primary Prevention initiative that employs Evidence-Based Prevention Programs and Policies, which includes strategies directed at the following populations: children, youth,  young adults, and/or families.  Article 2 Definitions and Acronyms  Term  Definition  An Excel workbook, filled in by the Contractor, which organizes the key activities and processes toward executing the chosen foundational and supplemental strategies. It includesa comprehensive program summary, outcome statement, and outlines CSAP strategy usage. CSAP: strategy information provides a structure to guide the Contractor through implementation oft their program and which milestones and activities they seek to complete each year. The Contractor will submit an. Action Plan (template provided) for each State Fiscal Year and may update the plan quarterly in conjunction with Department staff. Specific types of potentially traumatic experiences that occur to people under the age of18. The 10 core ACEs are divided into 3 categories: abuse (physical, sexual, and moliomalpycholegica), incarceration, and separation/divorce). ACEs have been linked to chronic health conditions and risky health behaviors, including Each Contractor must choose at least one evidence-based program or policy from the approved list that is categorized into one oftwo SAMHSA- Center for Substance Abuse and Prevention (CSAP) foundational strategies - Education or Environmental. Ifan evidence-based program is chosen, it will align with the Education strategy. If an evidence-based policy is chosen, it will align with the Environmental strategy. Contractor can choose more than one evidence-based program or policy to implement. Contractors then must choose one or more supplemental CSAP strategies - Information Dissemination, Alternatives,  Action Plan  Adverse Childhood neglect (physical and molioma/psychologica), and household Experiences (ACEs) dysfunction (substance abuse, mental illness, domestic violence,  substance use.  Centerfor Substance Abuse and Prevention (CSAP) Strategy  Page 2 of16  Amendment Contract Number: 2023*0329, Amendment #L    DocuSign Envelope ID:7 7AC8A5D7-BBBE-4F50-80E7-77BAB1819C97  EXHIBITB  Community-Based Processes, Problem Identification & Referral, Education or Environmental to accompany and support the selected EBP program or policy. Ifselecting two or more EBP programs or policies, each of the selected EBP programs or policies will: require a supplemental strategy. The evidence-based program or policy (Education or Environmental foundational CSAP: strategy) and supplemental strategy, when combined, will form a Comprehensive Af formal arrangement for cooperation and collaboration between groups or sectors ofa community. Each group retains its identity, but all agree to work together toward a common goal of building a safe, healthy, and drug-free community. Coalition intervention efforts can be categorized into providing information, enhancing skills, providing support, enhancing access/reducing barriers toj prevention services, changing consequences, changing the physical design oft the environment, and modifying or changing policies. Amodel which embraces the idea that no single organization can solve any major social problem by itself. Itt takes collaboration nonprofit, education, business, youth, and families - to achieve Al licensed and bonded entity that has the potential to successfully  Primary Prevention program or policy.  Coalition  Collective Impact between all community stakeholders- - including government,  long-term measurable change.  Commmtly-Based serveyouth and their families with selected program services. Iti may  Organization (CBO) bea a non-profit or faith-based organization.  The web-based data reporting system through which Contractor will submit process data relating to their SABG funded prevention An approach which aims to impact outcomes through multiple strategically aligned CSAP strategies. Contractor are: required to implement a Comprehensive Primary Prevention approach by utilizing data to inform the implementation of at least one foundational strategy (education, environmental) and at least one supplementary strategy (information dissemination, alternatives, community-based processes, or problem identification and referral) to support the implementation and effectiveness oft the foundational strategy and increase likelihood of favorable outcomes.  Colorado Prevention System  activities.  Comprehensive Primary Prevention  Page 3 of16  Amendment Contract Number: 2023*0329, Amendment: #1    DocuSign Envelope ID: 7AC8A5D7-BBBE-4F50-80E7-77BAB1819C97  EXHIBITB  The ability of an individual or organization to interact effectively with and provide services equitably to members of diverse population groups. Culturally responsive individuals and organizations can learn from and relate respectfully toj people from your own and other cultures. Prevention professionals should broaden their understanding and acceptance of cultural and individual differences and, in sO doing, render services and provide information sensitive to those htps/wwwsamhsaovsection-225/culurak-competency/esourees Ap process of critically examining an intervention. Iti involves collecting and analyzing information about an intervention's activities, characteristics, and outcomes. The purpose of evaluation is to make judgments about, improve, and communicate about the Ad document which details the process of evaluating aj program or Scientific research which indicates whether an intervention has been shown to influence and/or change an outcome ofir interest. Programs and policies which have been shown, through multiple rigorous research studies, to positively impact selected outcomes in the target population. Please contact Department staff for an approved list of EBP programs and policies. The extent to which delivery of an intervention adheres to the protocol or program model originally developed. Characteristics to consider when assessing fidelity include the target population, setting, number and timing ofs sessions or implementations, method ofdelivery, order, and content oft the intervention components, and more. Increased fidelity improves the odds that an intervention will Preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by linguistic minorities; those with low socioeconomic status; LGBTQ+ individuals; and more. Health equity is achieved when everyone has  Cultural Competence & Responsiveness  differences. For more information, visit:  Evaluation  effectiveness ofa an intervention.  Evaluation Plan Evidence Evidence-Based Programs and Policies (EBPs)  policy over the course oft the Grant Cycle.  Fidelity  work as intended.  Health. Disparities socially disadvantaged populations such as racial, ethnic, and  Page 4 of16  Amendment Contract Number: 2023*0329, Amendment: #1    DocuSign Envelope ID: 7AC8A5D7-BBBE-4F50-80E7-77BAB1819C97  EXHIBITB  ai fair andj just opportunity to be as healthy as possible, regardless of Programs and policies whose effectiveness is supported by some evidence, but which do not currently reach the level of evidence based. Innovative programs also target one or more of priority subpopulations listed in the Innovate Prevention Program RFP. Innovative programs include (1) adaptations of existing EBPs which better meet the needs ofaj priority subpopulation, and (2) independent programs/policies specifically developed to reach aj priority Asystematic and visual way to describe the sequence of related events connecting the need for the planned strategy with the strategy's desired results. A logic model shows the clear connection between the resources put into a strategy, activities required to implement the strategy, the number or number of products or services tol be provided, short- and medium-term outcomes expected to result from the strategy, and long-term impacts. For more information on the purpose, components, and structure of logic models, visit: htpyMAkfisuelaborremnempemepetomance As set of15 standards set forth by the U.S. Department ofHealth & Human Services which aim to improve healthcare quality and standard is to, "Provide effective, equitable, understandable and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy and other communication needs." For a full list ofthe CLAS tips/minoriyhealth.isgovminortv-menta-heatinchsy The result that an intervention aims toi influence and/or change. Outcomes typically reflect behaviors, such as reducing 30-day use of substances. Interventions may also impact knowledge (e.g., knowledge of health impacts of vaping), attitudes (e.g., perception of risk of harm of using marijuana), or skills (e.g., peer refusal skills in  social group.  Innovative Programs and Policies  subpopulation  Logic Model  Vitl-logic-models.htm  National Standards advance health equity by establishing a framework for organizations for Culturally and to serve the nation's increasingly diverse communities. The principal  Linguistically Appropriate Services (CLAS Standards)  standards, visit:  Outcome  youth).  Page 5 of16  Amendment Contract Number: 2023*0329 Amendment #1    DocuSign Envelope ID: 7AC8A5D7-BBBE-4F50-80E7-77BAB1819C97  EXHIBITB  An intentional, prosocial approach that engages youth within their communities, schools, organizations, peer groups, and families, in a manner that is productive and constructive. PYD recognizes, utilizes, and enhances young people's strengths, and promotes positive positive relationships, and building on their leadership trenghshtpsy/lphe.adlamabsnuicmulamtchi-halihmait. Ai framework that aims to keep an adverse outcome from occurring or becoming established by reducing risks or increasing resilience. There are two primary efforts: (1) to reduce dysfunction or promote health before the onset of disorder, and (2) to be population-focused, targeted to either the whole population or to subgroups with known Data which describes the internal processes of an organization or intervention, including but not limited to staff! hours worked, hours of trainings attended, number ofintervention implementations, and Specialized training, formal or informal education, or advanced professional learning intended tol help professionals improve their knowledge, competence, skill, and effectiveness. Characteristics of an individual, family, or community which are known to be associated with an increase (risk factors) or decrease (protective factors) ini the likelihood ofc developing an undesirable health Outcome. Characteristics which predict more than one Outcome are known as shared Risk and Protective Factors (e.g., family conflict is associated with both mental health problems and substance use). Primary Prevention aims to decrease substance use by decreasing risk factors and increasing protective factors related to Af framework used tol help guide goal setting. SMART is an acronym  Positive Youth  Development (PYD) outcomes for young people by providing opportunities, fostering  ve-youth-development  Primary Prevention  vulnerabilities.  Process Data  numbers served or reached  Professional Development  Risk and Protective Factors  substance use. that stands for:  SMARTGoal  Specific: Well-defined, clear, and unambiguous. Measurable: Includes criteria that measure your progress towards the accomplishment of the goal. Achievable: Attainable and realistic to achieve.  Page 60 of16  Amendment Contract Number: 2023*0329. Amendment: #1    DocuSign Envelope ID: 7AC8A5D7-BBBE-4F50-80E7-77BAB1819C97  EXHIBITB  Relevant: Directly related to your desired outcome. Timely: With a clearly defined timeline, including a starting An example ofa SMART goal could be, "In order to improve my health, I will do aerobic exercise for at least 20 consecutive minutes, 31 times per week for the next 61 months." For more information on htps/wwwsmartslectom/biop/essental-guxde-writing-smart-goals Amodel which explains how behaviors form based on characteristics ofindividuals, communities, nations, and levels in between. The model emphasizes multiple levels ofinfluence (such as individual, interpersonal, organizational, community, and public policy) and that behaviors both shape and are shaped by the social environment. SAMHSA's planning model to support coordinated, data-driven planning and accountability in prevention. The model consists off five principles (sustainability and cultural competence) which are Occurs when aj person's use of alcohol, marijuana, or other drugs leads to health issues or problems at work, school, or home. The SABG guidelines include Primary Prevention activities that are directed at individuals who do not require treatment for SUD. SABG Primary Prevention set-aside funds can only be used to fund strategies that are intended to prevent substance misuse and abuse and cannot be used to fund treatment activities or referral to  date and a target date.  SMART goals, visit:  Socio-Ecological Model  Strategic Prevention dynamic and iterative steps (assessment, capacity building, planning, Framework (SPF) implementation, and evaluation) and is guided by two primary  integrated into each step.  Substance Use Disorder (SUD)  treatment.  A1 framework in which programs simultaneously address the needs of parents and children toi improve Outcomes for the whole family. Fragmented approaches to serving families can leave either the child or the caregiver behind, reducing the likelihood ofs success for all members oft the family. 2Gen approaches draw from findings that the well-being of parents is crucial to their children's social-emotional, Involves approaches that address the overarching factors that are largely outside oft the control of the individual and which have significant trickle-down effects on other determinants ofhealth.  Two-Generation (2Gen). Approach  physical, and economic well-being  Upstream Prevention  Page 7of16  Amendment Contract Number: 2023*0329. Amendment: #1    DocuSign Envelope ID: AC8A5D7-BBBE-4F50-80E7-77BAB1819C97  EXHIBITB  Upstream interventions and strategies focus on improving social structures and systems in a community in order to decrease risk factors and increase protective factors that allow people to achieve their fulll health potential. Upstream interventions can benefit larger numbers of people and may be ultimately more effective than downstream individual-level interventions. Q1J July 1- September 30; Q2 October 1-1 December 31; Q3 January 1-N March 31; Q4. April 1-. June 30.  Quarter  Article 3  Work Plan: Activities and Services  Contractor shall provide primary, upstream substance abuse and misuse primary prevention services to children, youth, young adults, families, and communities in Colorado. The content below includes the requirements oft the Contractor. This section details the critical work necessary to meet the deliverable(s) oft the contract. This section should be detailed and specific and is what the contract monitoring team will review and the program staff needs to monitor for  invoice approval.  3.1 Strategic Prevention Framework (SPF)  a. Contractor shall complete and submit a one-year Action Plan (template to be provided) detailing proposed activities to bei implemented during the year, Contractor shall have the opportunity to update the Action Plan on a quarterly basis in consultation with, and  approval from, the Program Manager and evaluation staff.  b. In accordance with the SPF model, Contractor shall complete substance abuse and misuse primary prevention activities with the five SPF stages in mind: Assessment, Capacity Building, Planning, Implementing, and Evaluation. The Contractor shall also make Cultural Responsiveness and Sustainability an integral part of each phase.  1. Contractor shall review and update the five-year strategic plan. The strategic plan builds upon the original application, existing data, the readiness assessment and shall include but is not limited to: a) Identification of challenges that the community faces and strategies b) Identification and description of data and process behind strategy C) Identification oft the party/parties responsible for implementation  to address them. selection. oft the strategies.  Page 8 of16  Amendment Contract Number: 2023*0329. Amendment #1    DocuSign Envelope ID: 7AC8A5D7-BBBE-4F50-80E7-77BAB1819C97  EXHIBITB  d) Identification of the expected timeline for implementation ofthe Al Logic Model that illustrates inputs; activities; outputs; short,  strategies.  medium, and long-term Outcomes. f) Sustainability planning  Evidence Based Programs & Policies  1. Contractor shall implement the chosen EBP with Fidelity. 2. Contractor shall implement the EBP with the following parameters: a) Maintain a comprehensive substance abuse andi misuse primary prevention program that includes at least one oft the following Center for Substance Abuse Prevention (CSAP) strategies as a  foundational evidence-based strategy: Education ii. Environmental supplemental strategies as needed: Problem Identification and Referral ii. Information Dissemination iii. Community-based Processes iv. Alternative Activities V. Education vi. Environmental  b) Incorporate at least one or more ofthe following CSAP  3. Contractor shall guarantee that most funds are dedicated to and support the chosen evidence-based program or policy (Education or Environmental foundational strategies). Contractor shall track spent funds throughout the State Fiscal Year (July 11 to. June 30) by demonstrating and reporting that most funds support the EBP program or policy in the Year-end Outcome 4. Contractor shall ensure that all the strategies and activities implemented are directly related to the planned activities noted ini the Action Plan. All the outlined activities shall be directly related tot the identified Risk and 1. Contractor shall promote community efforts to raise awareness and generate support from multiple community sectors for the intended EBP 2. Contractor shall have critical support from county commissioners, existing Coalitions, and other community partners with similar goals within its  Progress Narrative Report (template provided).  Protective Factors and prevention outcomes.  d. Collaboration Collective Impact Approach  program or policy.  geographical target area.  Page 9 of16  Amendment Contract Number: 2023*0329. Amendment: #I    DocuSign Envelope ID: 7AC8A5D7-BBBE-4F50-80E7-77BAB1819C97  EXHIBITB  3. Contractor shall consider implementing a 2Gen approach to create opportunities for both youth and the adults in their lives together. 1. Contractor shall use local data toi identify subpopulations in the community that are experiencing disparities and continue to work towards reducing these disparities as identified in thel Five-Year Strategic Plan. 2. Contractor shall use the CLAS Standards tol help the organization and programs take into account cultural health beliefs, preferred languages, health literacy levels, and communication needs. 3. Contractor shall submit a CLAS implementation checklist and action worksheet to guide organization and program practices. Follow up on action worksheet will be addressed during site visits,  Health Equity and National Standards for Culturally and Linguistically Appropriate  Services (CLAS Standards)  3.2 Required Training and Technical Assistance (TA) a. Contractor shall attend the following required trainings:  1. The Colorado Shared Risk & Protective Factors Conference annually. The conference committee is planning on an in-person conference or virtual option. Budgets should reflect in-person costs (i.e. mileage, hotel, per diem). Registration costs should be captured in the Supplies 2. Substance. Abuse Prevention Skills Training (SAPST). and Prevention Ethics' Training for all staff positions included in the budget that have not taken these two trainings previously. All program staffworking at .25 FTE or more on the contract shall complete these two training sessions within a timeframe acceptable to the Program Manager.  & Operating category on the budget form.  b. Contractor shall work with the assigned Program Manager, assigned evaluation staff, and The Department will provide technical assistance.. Additional training and' TA must be  the assigned technical assistance provider.  approved in advance by your designated Program Manager.  Page 10of16  Amendment Contract Number: 2023*0329 Amendment #1    DocuSign Envelope ID: 7AC8A5D7-BBBE-4F50-80E7-77BAB1819C97  EXHIBITB  Article 4 Deliverables  4.1 Deliverables Table  a. Items shall be emailed to the Program Manager/evaluation staff unless otherwise specified in the table below. Reimbursement of expenses shall be contingent upon receipt  ofdeliverables by the specified deadline.  Deliverable Annual Action Plan  Date*  Method ofDelivery  Template provided to grantees Email tol Program  July 1, annually Annual Action Plan due. July 30, annually  Manager and evaluation staff  Action Plan - quarterly updates  Q2-October to December annually Q3-J January to March changes due by December 30, annually Q4-A April to. June changes due by March 31, annually  Email to Program staff  changes due by September 30, Manager and evaluation  Implementation Process  Q1-J July to September* Q2- October to December* Q3 -. January to March*  Via Colorado Prevention System online database  Data  Page 11 of16  Amendment Contract Number: 2023*0329. Amendment #1    DocuSign Envelope ID: 7AC8A5D7-BBBE-4F50-80E7-77BAB1819C97  EXHIBITB  Q4-April to June - due June * Due on the last working day ofthej following month at the end of the quarter  30  NOMs and PAPO pre/post Submit surveys annually or Email Program and  surveys  within established timeline such as when a session is completed  Evaluation staff when surveys are being mailed to CDPHE. Mail paper pre/post surveys to CDPHE following instructions Email to Program Manager and evaluation staff  Review and update (as needed) Five-Year Strategic Plan Review and update (as needed) Five-Year Evaluation Plan Year-end Outcome including any additional evaluation reports Substance Abuse (SAPST) and Prevention Ethics Training Certified Prevention Specialist certification  September 30, annually  January - March 30, annually Email tol Evaluation staff  and CC Program Manager  September 30, annually. Final Email tol Program  Progress Narrative Report year off five year grant cycle Manager, CC evaluation  due by June 30th.  staff  Completed within at timeframe Email certificate to  Prevention Skills Training acceptable to the Department Program Manager  Grant Project Coordinator to Email certificate to complete by two years ofh hire Program Manager  start date  Page 12of16  Amendment Contract Number: 2023*0329. Amendment #1    DocuSign Envelope ID: 7ACBA5D7-BBBE-4F50-80E7-77BAB1819C97  EXHIBITB  Colorado Shared Risk and Attend annually. State will  Submit certification of attendance to Program Manager  Protective Factor Conference Data and Evaluation training  follow CDC guidelines Attend annually  Participation in training. evaluation staff will verify attendance Manager cce evaluation staff  Grant-indicated staff changes  Within 101 business days of Email to Program  the change  Monthly StaffHours Cost Once a month by the 15th of Via Colorado Prevention  Allocation Submission  the following month except System online database  for June which is due June 30,  annually  Community Visit- organization  At least once during the five Grant Project  conducted at Contractor's year grant cycle  Coordinator and other staff working on the contract. Program Manager and evaluation staff shall facilitate.  Compliance Calls  Every month/bi-monthly or Participation in call.  quarterly or as needed  Program Manager and evaluation staffv will verify attendance Email to Program staff  CLAS implementation Checklist and Action Worksheet  Check in on progress made and update (as needed)  towards the 3 goals. Review Manager, CC evaluation  *Dates are. subject to change at the discretion of the Department.. Any due dates beyond the initial contract periodof. July 1, through. June 30 are contingent upon executing contract renewals, funds being appropriated, budgeted, and otherwise made available, and other contractual requirements, ifapplicable, being satisfied.. Ifany discrepancies exist between. Article 3- Work  Plan: Activities and Services and Article 4- Deliverables, Article 4- Deliverables prevails.  Page 13 of16  Amendment Contract) Number: 2023*0329, Amendment #1    DocuSign Envelope ID:  EXHIBITB  Article 5  Performance Outcome Measures  5.1 Monitoring: The Department's monitoring oft this contract for compliance with performance requirements will be conducted throughout the contract period by the Program Manager and evaluation staff. Methods used will include ai review of documentation determined by the Department to be reflective of performance to include progress reports and other fiscal and programmatic documentation as applicable. The Contractor's performance will be evaluated at set intervals and communicated to the contractor. A] Final Contractor Performance Evaluation 5.2 Administrative and Compliance Requirements: To ensure active contract management and delivery ofc quality substance abuse and misuse primary prevention services to communities throughout Colorado, Contractor is responsible for the following administrative and compliance  will be conducted at the end oft the life oft the contract.  activities:  a. Communications Between Contractor and Department staff  1. All email and phone inquiries made by Department staff, or the Contractor 2. Grant Project Coordinator (or approved appointee) shall participate in compliance calls with the Program Manager and evaluation staff at a 3. Contractor shall be available for calls between compliance calls as the 1. Performance monitoring Contractor shall submit Process Data into the Colorado Prevention System, the web-based data reporting system. Staff hours spent toward grant-funded projects supported by the contract shall be entered monthly. Implementation and demographic data shall be 2. Reporting Contractor shall submit a Year-end Outcome Progress 3. Quality Improvement Contractor shall use data to inform decision-making and toi improve project implementation and outcomes. 1. Contractor shall participate (at minimum) in-person community visit conducted by Department staff at least once during the five year grant cycle. Department staff shall provide Contractor with a document outlining required documentation at least 10 working days prior to the community visit and Contractor shall provide all requested documentation at the community visit. Department staff shall draft ai narrative report of  shall be responded to within 31 business days. minimum ofe every three months.  need arises.  b. Quality and Performance Management  entered quarterly.  Narrative Report (template provided).  C. Grant ManagemenvComplance  Page 14 of16  Amendment Contract] Number: 2023*0329. Amendment: #1    DocuSign Envelope ID: 7AC8A5D7-BBBE-4F50-80E7-77BAB1819C97  EXHIBITB  the community visit that shall then be available for the Contractor's a) Atn minimum, Contractor shall have the following available for  review and: records. review:  Agency policies and procedures to assist with grant  compliance ii. Agency organizational chart contract certifications and budget  iii. Department sub-contracts and MOUS supported by this iv. Proofofattendance for mandatory trainings and V. Strategic plan, Evaluation Plan, Logic Model, Action Plan,  5.3 Evaluation & Outcome Measurements: To ensure that federal reporting requirements to SAMHSA are met, Contractor shall participate in the following Department data  collection and evaluation efforts:  1. Any newly hired Grant Project Coordinator shall attend training on the use oft the Colorado Prevention System within two months of their hire date. a. Ifstaffing changes require new: staff to work with the system, the staff member shall complete training with the assigned evaluation staffbefore  being granted system access. trainings will be provided by Department staff.  2. Contractor shall complete required data and evaluation training annually. These 3. Contractor shall review and update the Process Data Entry Plan annually and as 4. Contractor shall review the Five-Year Strategic Plan and make updates as needed. 5. Contractor shall review the Five-Year Evaluation Plan and make updates as 6. Contractor shall not change the three- and five-year Outcome statements, as approved in the Five-Year Evaluation Plan, without written approval by the 7. A data submission timeline, including monthly submission of cost allocation hours as well as process and outcomes data submission at least annually. 8. Contractor shall track and regularly communicate information related to the process (e.g., staff hours by program, numbers served, etc.) through the Colorado 9. Staffhours shall be reported through the Colorado Prevention System monthly. Other process data shall be reported on a data reporting cycle as specified by  needed. needed.  Program Manager and evaluation staff.  Prevention System.  Page 15of16  Amendment Contract Number: 2023*0329. Amendment #1    DocuSign Envelope ID:  EXHIBITB  evaluation staff (e.g., monthly, quarterly, annually, depending upon the type and 10. Contractor shall collect and report on required performance measures (National Outcome Measures [NOMs] and Prevention Assessment of Program Outcomes [PAPO] including changes to risk and protective factors and behavior Outcomes (substance use and otherwise) using al Department-provided measurement tool. 11. Contractor shall submit required NOMs and PAPO pre/post survey data annually or within established submission timelines such as when a session is completed. Paper surveys shall be mailed to CDPHE following instructions provided by 12. Contractor shall capture all individual-level data collected (i.e., attendance sheets, etc.) through Outcome tools supplemental tot those required sO long as the program is funded through SABG and shall provide these data to the evaluation or 13. Contractor shall communicate outcomes data and results per submission timelines and shall be framed within the appropriate context with community members and other collaborative organizations. Contractor shall utilize data within the agency to improve understanding of populations served, their needs, and program 14. Contractor. shall share any additional evaluation activities (above and beyond the requirements for evaluation and outcome measurements) oft the implemented EBP program or policy as requested. This can include but is not limited to  availability of the data).  evaluation staff.  program staffwithin 15 working days ofr request.  administration on an annual basis.  measurement tools, data collected, and reports.  5.4 Resolution ofNom-Complance: The Contractor willl be notified in writing within 15 calendar days of discovery ofa compliance issue. Within 30 calendar days of discovery, the Contractor and the State will collaborate, when appropriate, to determine the action(s) necessary to rectify the compliance issue and determine when the action(s) must be completed. The action(s) and timeline for completion will be documented in writing and agreed to by both parties. Ifextenuating circumstances arise that requires an extension tot the timeline, the Contractor must email a request to the Program Manager and receive approval for a new due date. The State will oversee the ompetommpemetaton ofthe action(s) to ensure timelines are: met and the issue(s) is resolved. Ifthe Contractor demonstrates inaction or disregard for the agreed upon compliance resolution plan, the State may exercise its rights  under the provisions oft this contract.  Page 16of16  Amendment Contract Number: 2023*0329, Amendment #1    DocuSignE Envelopell ID:  Exhibit CE Budget  COLORADO Department of Public Health 81 Environment  PREVENTION SERVICES DIVISION- 12 MONTH BUDGET WITH. JUSTIFICATION FORM  Original Contract Routing #CT FHLA: 2023*0329  Program Contact Name, Meagan Hillman, Director Fiscal Contact! Name, Reyna Perez, Accountant  Contractor Name Prowers County Public! Healtha andE Environment Title, Phone andE Email  719-336-8721, imanepowercounmynet 719-336-8721 maNewsat CTFHLA2023-0329  BudgetF Period Project! Name  7/1/2023-6/30/2024 URHN  Title, Phone and Email Contract (CTorP PO) Number  Expenditure Categories Personal: Services Salaried Employees  Gross or Salary  Percent of TotalA Amount Proiect 5.0%$  Position Title Project Manager Administrator  Description ofv Work Coordinate grant, facilitators, ensure deliverables pension, PTO, insurance Work with Project Manager to coordinate projects.  Annual Fringe Time on Requested from  CDPHE 6,528.26  arer meti inat timely manner. Fringeir includes $58,501.28 $8,285.12 50.09$ 33,393.20  $109,676.76 $20,888.34  Personal Services Hourly Employees  Total#of TotalA Amount Project  Hourly  Position1 Title PHStaffer  Description of Work  Hourly Wage Fringe Hours on Requested from $36,945.96 $13,094.52 25.0%$  CDPHE 12,510.12 52,431.58 Total Amount 12.0$ 1.00 $ 2.00 $ 1.00 $  Assist Project Manager  Total Personal Services (including fringe benefits)) $  Supplies & Operating Expenses Description ofl Item  Item Building Rent Utilities for Building Gas andE Electric SEL Programming SRPFC Conference Communication Copies Offices Supplies  Rate Quantity Requestedi from  Council meetings andy youth nightl locations rentalf fees, and associated costf fort the FY23 ($1500x12 months) (Excluded from $1,500.00 SELP Programming ands support fors schools and activities Project Manager and PH'S Stalfer/Adminlstrator SMADdOAAaNAE fory youth ands stafft to wear Office phone/cell phone (12 months) x$50.) Flyers, reminder postcards/nvitationsl ($1. 50x600) Sticky pads, markers, pens, notepads, etc.  18,000.00 excluded fromi indirect 1,020.00 7,200.00 5,761.55 400.00 500.00 725.00 3,750.00 600.00 900.00 600.00]  Indirect)  Internet for Building Internet access fory youth council meeting andy youthr nights $ 85.00 12.00 $  $ 600.00 12.00 $ $ 5,761.55 $ 40.00 10.00$ $ 250.00 $725.00 $ 15.00 250.00$ $ 50.00 12.00$ 1.50 600.00 $ $ 50.00 12.00 $  Background Checks Background checks fory youth council faciliators NACCHO 360 Conference Project Manager and/ Administrator Vouth Council Branding toevents, stickers forf folders  Amendment Contract Number: 2023*0329, Amendment #1  Page 1of3    DocusignE Envelopel ID: ACBA5D7-  Exhibit CE Budget  Supplies fory youthi initiated projects (40 councils). Supplies are focused ond communityi involvement: andy youth prosocial opportunities. Items expectedt tobe purchased are: books for little library projects, moviesi int thep park, supplies forr moviesi in $ 1,982.00 thep park, art&o crafts supplies, supplies ford community: service projects (Supplies can vary duet tos student deas/mplementation), Art& craft supplies, suppliesf forp projects, variety ofa age- relateds supplies, paper towels, soap, cleaning projects, seating, tables, décor, supplies Food at $70/sessiont fory your nightsf for 45r nights Conference orp prevention-1 related professional development Manager Alcohol and drugf free after proms support forf four school districts within Prowers County  Youth Project Implemenation  4.00$  7,928.00  Youth Council Meeting appropriate games andv video games, miscellaneous program $ 1,365.00 Foodi for) Youth Council Fooda at$ $120/sessionx4 locations ford council meetings for 45  4.00 $  5,460.00  Supplies Meetings and Youth weeks. Nights  $25,875.00  1.00$ 25,875.00  Professional Development (with approval ofA Administrator, Commissioners)t for Project $ 500.00 1.00$  500.00 2,000.00 81,219.55 Total Amount 975.00 6.00 $ 600.00 900.00 6.00 $ 3.00 $ 900.00 3.00 $ 525.00 $ Total Travel $ 3,900.00 Total Amount CDPHE 4,500.00 2,400.00 9,000.00 9,000.00 9,000.00  Mini Grants  $ 500.00 4.00$ Total Supplies & Operating $  $  Travel  Item Mileage Per Diem Lodging Conference Lodgingf for SRPF Conference  Description of Item  Rate Quantity Requestedf from $ 0.65 1500.0 $ $ 100.00 $ 300.00 $ 175.00  Local mileaget to grant programming Per diemf forF Project Managera andP PHs staffer (6 days in: state travelx x2s staffx $50/day/person) Project Manageri ins state travel; coste estimateda at$ $150/nightx6 $ 150.00 nights)  Lodgingf for NACCHO3 360 coste estimateda ats $300/nightx x3nights  coste estimateda ats $175/night) x3nights  Contractual Description ofitem  Subcontractor Name  Rate Quantity Requested from $100.00 45.0$ $100.00 $200.00 $200.00 $200.00  Vouth nightf facilitatorsi foru use atP Prowers County" Youth Council Youth Social Media Specialist toc collaborate: and create social projects @ $100.00 perc completedp project.)  Vouth Night Facilitators "Youth Night" (1f facilitators at$ $100/session x45 sessions. Social Media Contractors media content fort they youth councils. (creating 24 media Councit Facilitator for Adulti facilitators toa attend weeklyo councilr meetings (2 Youth Council- Lamar facilitators at $100/session) x45s sessions.) Council Facilitator for Adultf facilitators toa attend weeklyo council meetings (2 Youth Council- Wiley facilitators at$ $100/session) 45s sessions.) Council Facilitator for Adult facilitators toa attend weeklyo council meetings (2 Vouth Council- Granada facilitators ats $100/session) x45s sessions.) Council Facilitator for Adult facilitators toa attendv weekly council meetings (2 Youth Council- Holly facilitators at 100/session> 45s sessions.)  24.0$ 45.0$ 45.0$ 45.0$  $200.00 45.0$, 9,000.00 Total Contractual $ 42,900.00 SUB-TOTAL OF DIRECT COSTS $ 180,451.13  Amendment Contract Number: 2023*0329, Amendment: #1  Page 2of3    DocusignE Envelopel ID:  Exhibit CI Budget  Indirect Description ofl Item  Item Indirect Cost Rate CDPHE- Negotlated Den minimis Indirect Cost  TotalA Amount 19,542.87 19,542.87  Federally-Negotiated Tobe: applledt towards personnel time noth billable ont theg grant ando other costs assoclated  with grant management. (Indirect Rate= 12.03%)  Total Indirect $ TOTAL $ 199,994.00  Amendment Contract Number: 2023*0329, Amendment #1  Page 3of3    DocuSign Envelope ID: 7AC8A5D7-BBBE-4F50-80E7-77BAB1819C97  Exhibit) F  Federal Provisions- Substance Abuse Prevention & Treatment Block Grant For thej purposes oft this Exhibit only, Contractor is alsoi identified as Subrecipient." This Contract has been funded, in whole ori in part, with an award of] Federal funds. Ini the event ofa conflict between the provisions of these Supplemental Provisions for Federal Awards, the Speciall Provisions, the Contract or any attachments or exhibits incorporated into andi made aj part oft the Contract, the Supplemental Provisions for Federal Awards shall control. Int the event ofa conflict between the Supplemental Provisions for Federal Awards and thel FFATA Supplemental: Provisions (ifany), thel FFATA  Supplemental Provisions shall control. Federal Award Identification.  a. Subrecipient: Prowers County Public Health b. Subrecipient Unique Entity Identification Number: d. The Federal award datei is 02/10/2022.  SAM Unique Entity ID (UEI): Y8C4HSXY95M6 The Federal Award Identification Number (FAIN) is B08TI084634.  . The subaward period of performance start date is 10/01/2021 and end date is 09/30/2023.  f. Federal Funds: Federal Budget Period 10/01/2021 9/30/2023  Total Amount of Federal Funds Awarded $7,229,378.00  Amount of Federal Funds Obligated to CDPHE $7,229,378.00   Federal award title of project or program: Substance Abuse Prevention & Treatment h. The name of the Federal awarding agency is: Department of Health and Human Services, Substance Abuse and Mental Health Services Administration Center for Substance Abuse Treatment and the contact information for the awarding official is Charlotte Olson, charlotte.olson@samhsa.hhs.goy; the name ofthe pass-through entity is the State of Colorado, Department of Public Health and Environment (CDPHE), and the contacti information for the CDPHE official is Robert Werthwein, The Catalog of] Federal Domestic. Assistance (CFDA) number is 93.959 and the grant name is Block Grants for Prevention and Treatment of Substance Abuse. k. Subrecipient is not required toj provide matching funds. Ini the event the Subrecipient is required toj provide matching funds, Section 8 oft this Attachment applies. Thei indirect cost rate for the Federal award (including ifthe de minimis rate is charged per 2 CFR $200.414 Indirect (F&A) costs) is pre-determined based upon the State of Colorado and  Block Grant.  cetwerhangstccous  This award is not for research & development.  CDPHE cost allocation plan.  Page 1of4  Amendment Contract Number: 2023*0329. Amendment #1  Ver. 25.02.20    DocuSign Envelope ID: AC8A5D7-BBBE-4F50-80E7-77BAB1819C97  2) Subrecipient shall at all times during the term oft this contract strictly adhere toi the requirements under thel Federal Award listed above, and all applicable federal laws, Executive Orders, andi implementing 3) Any additional requirements that CDPHE: imposes on Subrecipient in order for CDPHE toi meeti its own responsibility to the Federal awarding agency, includingi identification ofa any required financial and 5) Subrecipient must permit CDPHE and auditors to have access to Subrecipient's records and financial statements as necessary for CDPHE to meet the requirements of2 CFR $200.331 Requirements for pass- through entities, SS 200.300 Statutory and National Policy Requirements through $200.309 Period of 6) The appropriate terms and conditions concerning closeout oft thes subaward are listed in Section 160 of 7) Performance and Final Status. Subrecipient shall submit all financial, performance, and other reports to CDPHE nol later than 45 calendar days after the period of performance end date or sooner termination of this Contract containing an evaluation and review of Subrecipient's performance andi the 8) Matching Funds. Subrecipient shall provide matching funds as stated in the Exhibits. Subrecipient shalll have raised the full amount of matching funds prior to the Effective Date: ands shall report to CDPHE regarding the status ofs such funds upon request. Subrecipient's obligation toj pay all or any part of any matching funds, whether direct or contingent, only extends to funds duly and lawfully appropriated for the purposes of this Contract by the authorized representatives oft the Subrecipient andj paidi into the Subrecipient's treasury or bank account. Subrecipient represents to CDPHE that the amount designated as matching funds has been legally appropriated: for thej purposes oft this Contract by its authorized representatives and paidi intoi its treasury or bank account. Subrecipient does not by this Contract irrevocably pledge present cash reserves for payments in future fiscal years, and this Contract is not intended to create ai multiple-fiscal year debt oft the Subrecipient. Subrecipient shall not pay or be liable for any claimed interest, late charges, fees, taxes or penalties of any nature, except as required by 9) Record Retention Period. The record retention period previously stated in this Contract is replaced 10) Single Audit Requirements. IfSubrecipient expends $750,000 or more in Federal Awards during Subrecipient's fiscal year, Subrecipient shall procure or arrange for as single or program-specific audit conducted for that year in accordance with the provisions of Subpart F-Audit Requirements oft the Uniform Guidance, issued pursuant to the Single Audit Act Amendments of 1996, (31 U.S.C. 7501-7507). 2CFR 11) Contract Provisions. Subrecipient shall comply with and shall include all oft the following applicable a. Office of Management andl Budget Circulars and' The Common Rule for Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local b. when required byl Federal program legislation, the Davis-Bacon Act", as amended (40 U.S.C.3141-3148) as supplemented! by Department ofLabor Regulations (29 CFRI Part 5, "Labor Standards Provisions Applicable to Contracts Covering Federally Financed and  regulations as they currently exist andi may hereafter be amended.  performance reports, are statedi in the Exhibits.  4) Subrecipient's approved indirect cost rate is as stated int thel Exhibits.  performance, and Subpart F-Audit Requirements ofthis Part.  this Attachment.  final status of Subrecipient's obligations hereunder.  Subrecipient's laws or policies.  with thei record retention period prescribed in 20 CFR $200.333.  $200.501.  provisions in all subcontracts entered into by itj pursuant tot this Contract:  Governments, as applicable;  Assisted Construction");  Page2 2of4  Amendment Contract Number: 2023*0329. Amendment: #1  Ver, 25.02.20    DocuSign Envelope ID: 7AC8A5D7-BBBE-4F50-80E7-77BAB1819C97  when required by Federal program legislation, the Copeland "Anti-Kickback" Act (40 U.S.C. 3145), as supplemented by Department ofI Labor regulations (29 CFRI Part 3, "Contractors and Subcontractors on Public Building of] Public Work Financed in' Whole ori in! Part by Loans d. 42U.S.C. 6101 ets seq., 42 U.S.C. 2000d, 291 U.S.C. 794 (regarding discrimination); the' "Americans with Disabilities Act" (Public Law 101-336; 42 U.S.C. 12101, 12102, 12111 12117,12131-1 12134, 12141-1 12150, 12161-12165, 12181 - 12189, 12201-1 12213 and47 when applicable, the Contractor shall comply with the provisions oft the "Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local Thel Federal Funding Accountability and' Transparency. Act of2006 (Public Law 109-282), as amended by $6062 of] Public) Law 110-252, including without limitation all data reporting requirements required there under. This Acti is also referred to as FFATA. h. Contractor shall comply with thej provisions of Section 601 ofTitle VI oft the Civil Rights Act Except as otherwise provided under 41 CFR Part 60, all contracts that meet the definition of "federally assisted construction contract": in 41 CFR Part 60-1.3 comply with the equal opportunity clause provided under 41 CFR 60-1.4(b), in accordance with Executive Order 11246, "Equal Employment Opportunity: (301 FR 12319, 12935,3 CFR Part, 1964-1965 Comp., p. 339), as amended by Executive Order 11375, "Amending Executive Order 11246 Relating tol Equal Employment Opportunity," and implementing regulations at 41 CFR part 60, "Office of] Federal Contract Compliance Programs, Equal Employment Opportunity, where applicable, Contract Work Hours and Safety Standards Act (40 U.S.C.3 3701-3708). ifthel Federal award meets the definition of"funding agreement" under 37 CFR $ 401.2(a) and the recipient or subrecipient wishes to enter into an agreement with a small business firm or nonprofit organization, comply with the requirements of37CFR Part 401, "Rights to Inventions Made by Nonprofit Organizations and Small Business Firms Under Government Grants, Contracts and Cooperative Agreements," and anyi implementing regulations issued by . the Clean Air Act (42 U.S.C. 7401-7671q.) andt thel Federal Water Pollution Control. Act (33 m. ifapplicable, comply with the mandatory standards andj policies on energy efficiency contained within the State of Colorado's energy conservation plan issued in compliance with n. the Contractor and allj principals are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from covered transactions by any federal department or agency; the Contractor and allj principals shall comply with all applicable regulations pursuant tol Executive Order 12549 (3 CFR Part 1986 Comp., p. 189) and Executive Order 12689 (3 CFR Part 1989 Comp., p. 235), Debarment: and Suspension; 0. the Contractor shall comply where applicable, thel Byrd Anti-Lobbying Amendment (31  or Grants from the United States").  U.S.C. 225 and 47 U.S.C. 611); Governments" (Common Rule);  of 1964, as amended.  Department ofLabor.  the awarding agency. U.S.C. 1251-1387), as amended.  thel Energy Policy and Conservation. Act, 42 U.S.C. 6201.  and, U.S.C. 1352).  Page3of4  Amendment Contractl Number: 2023*0329. Amendment: #1  Ver. 25.02.20    DocuSign Envelope ID: 7AC8A5D7-BBBE-4F50-80E7-77BAB1819C97  12) Compliance. Subrecipient shall comply with all applicable provisions of The Office of Management and] Budget Uniform Administrative Requirements, Cost] Principles, and Audit Requirements for Federal Awards (Uniform Guidance), including but not limited tot these Supplemental: Provisions for Federal Awards. Any revisions tos such provisions automatically: shalll become ap part ofthese Supplemental Provisions, without the necessity of either party executing any further instrument. CDPHE: may provide written notification to Subrecipient ofs such revisions, but suchi notice shall not be a condition precedent to 13) Procurement Procedures. Subrecipient shall use its own documented procurement procedures which reflect applicable State, local, and' Tribal laws andi regulations, provided that the procurements conform to applicable Federal law and the standards identified in the Uniform Guidance, including without limitation, 14) Certifications. Unless prohibited by Federal statutes or1 regulations, CDPHE may require Subrecipient to submit certifications and representations: required by Federal statutes or regulations on an annual basis (2 CFR $200.208). Submission may be required more frequently if Subrecipient fails to meet ar requirement of thel Federal award. Subrecipient shall certify in writing to CDPHE at the end ofthe Contract that thej project or activity was completed or the level of effort was expended. 20 CFR $200.201(b)(3). Ifther required level of activity or effort wasi not carried out, the amount oft the Contract 15) Event of] Default. Failure to comply with thel Uniform Guidance or these Supplemental Provisions for Federal Awards shall constitute an event of default under the Contract pursuant to 2CFR $200.339 and CDPHE may terminate the Contract in accordance with the provisions in the Contract. 16) Close- Out. Subrecipient shall close outt this Contract within 45 days after thel End Date. Contract close out entails submission to CDPHEI by Subrecipient of all documentation defined as a deliverable in this Contract, and Subrecipient's final reimbursement request. Ifthep project has not been closed by the Federal awarding agency within 1 year and 45 days after the End Date due to Subrecipient's failure to submit required documentation that CDPHE has requested from Subrecipient, then Subrecipient may be prohibited from applying for new. Federal awards through the State until such documentation has been 17) Erroneous Payments. The closeout ofal Federal award does not affect the right of thel Federal awarding agency or CDPHE to disallow costs and recover funds on thel basis ofal later audit or other review. Any cost disallowance recovery is tol be made within the record retention period.  the effectiveness ofs such revisions.  $$200.318 through 200.326 thereof.  must be adjusted.  submitted and accepted.  EXHIBITI END  Page4of4  Amendment Contract Number: 2023*0329, Amendment #1  Ver. 25,02.20