HomeMy WebLinkAboutbocc.con.170.2015rv-'� VA�A"
Rev. 08-30-11 jls
COUNTY CLERK'S
CONTRACT COVERSHEET
CONTRACT #: 17 (D - Zo �S
ORIGINATING DEPARTMENT: N-f�� 4�', k_c � �VU L
PROCUREMENT OFFICER: ,), j QQvTHONE #: �� q
PROJECT NAME: � Vt.� CONTRACTOR:
DOLLAR AMOUNT: `LS_oo . 0 INE ITEM # (2Z.
CONTRACT EXECUTION DATE: r?v (24
S—`CONTRACT END DATE: � c
AUTOMATIC RENEWAL: ❑ YES �NO TERM:
❑ BOCC AGENDA ITEM (Grants, IGA) STAFF AUTHORIZED SIGNATURE
(Requires BOCC Signature) (Per Revised Procurement Code 7/2005)
❑ OVER $50,000 (Requires Section Leader & County Manager's Signature)
✓ CHECK PROCUREMENT TYPE:
done ❑ Informal ❑ Formal ❑ Sole Source ❑ Emergency ❑ Outside Agency/State Bid
❑ Compliance with C.R.S. 8-17-5-101, 102 as amended (Immigration Form) ❑ Exempt
❑ Contract Renewal
✓ CHECK CONTRACT TYPE:
XServices/Maintenance ❑ Employment
❑'License/Use ❑ Intergovernmental Agreement (Resolution Required)
❑ Lease ❑ Non -Profit
❑ Construction ❑ Quasi -Public (e.g.-AVH)
❑ Goods, Equipment, Supplies ❑ Grant Agreements (Notify Finance & Resolution Required)
❑ Other (e.g. revenue) ❑ Change Order/Contract Amendment
(C/O: 10% or $25K whichever is the lesser must have County Manager signature)
All Contracts should be proofed and all exhibits and notices must be attached for the following:
✓ [�No Pages Missing ✓[All Other Blanks Filled In
✓ �f Page Left Intentionally Blank —Note on Page ✓❑All Exhibits Attached
✓ [-Page numbered consecutively ✓❑'All Legal Descriptions attached (fapplicable)
✓ 5]-A11 Original Signatures Affixed ✓D otice of Award/Notice to Proceed Attached (if applicable)
✓ ED All Dates Filled In <3 -Warranty (if applicable)
✓
[9 -Special Instructions for Finance Departme t:
✓Authorized Procurement Officer's Name: v
BY CHECKING ABOVE AND ENTERING NAME, THE AUTIIORIZED STAFF PERSON INDICATES THAT
THE ATTACHED DOCUMENT HAS BEEN PROOFED AND READY FOR SCANNING.
NOTE: CLERK'S OFFICE WILL KEEP ORIGINAL DOCUMENTS IN COMPLIANCE WITH COLORADO STATE
ARCHIVES RETAINAGE SCHEDULE. ALL ATTACHMENTS MUST BE WITH THIS CHECKLIST!
1-7
June 24, 2015
Early Learning Center
License number: 78935
Attention: Kelly Beal
RE: Infant and Toddler Quality Improvement Program ("ITQIP")
Dear Kelly,
Please be advised of the following regarding Early Learning Center ("The Program") recent ITQIP grant
application (the "Application") requesting an ITQIP grant award in the amount of $1,500 (the "award"):
1. The Application has been approved and the Award will be distributed to The Program by Pitkin
County in the amount of $1,500.
2. The use of the Award by The Program must be for the purpose of improving quality for infant
and toddler care including: LED Fluorescent replacement- greater energy efficiency and ability
to control lighting in 3 infant and toddler rooms and be documented with receipts.
3. Payment will be by reimbursement and must be completed before June 29, 2015. Receipts for
the completed purchase should be mailed/scanned/emailed to Shirley Ritter at Kids First
(Shirley.ritter@cityofasnen.com).
4. Any changes to the original agreement regarding The Program's intended use of any awarded
grant funds must be pre -approved in writing by Shirley Ritter, RRRECC member and Kid's First
Director.
S. ELC Director and Accountant agree to sign up for and participate in the CCAP Provider Self
Service Portal (PSSP) Provider training by July 30, 2015. Contact 1-888-509-1757 or
cdhs_pssp@state.co.us.
6. ELC Director agrees to implement the Parental Responsibilities for CCAP agreement (Attached
draft) by July 1St with all CCAP customers and reduce manual claims.
It is hereby acknowledged by The Program that the Award must be used by no later than June 29, 2015
(the Award Expenditure Deadline). In the event that any portion of the Award is not utilized by The
Program by the Award Expenditure Deadline, the remaining Award amount will be.forfeited by the
Program.
Applicant's Signature -Date: 3q (T-
30 2�a
Applicant's Name: Vewu e6i Date:_ 0 a
County Representative Signature:
e
County Representative Name: Date: