HomeMy WebLinkAboutbocc.con.280.2016A 7/2015 l:jm
/9i-rKIN Pitkin County
CouNT4 Contract Cover Sheet
-@z-,-No.
Please complete the Contract Cover Sheet when the contract is completed and signed by Contractor and Pitkin County
Project Manager.
Return all Contract Cover Sheets and Contracts/Change Orders/Amendments to Procurement
(procurement help@pitkincounty.com).Any contracts$50,000 and over will be routed for signatures to County Manager
and Attorney's Office(if required)by Procurement&Contracts Manager.
Contract Information
Contract Number 280.2016 A
Project Name Wellness and Administration Services
Contractor Healthbreak,Inc.
Budget Line Item 421.90.00000.82440
Additional Budget Line Item(s) Click here to enter text.
and special notes to Finance
Contract Start Date 9/1/2016
Contract End Date 9/30/2017
Automatic Renewal Yes ❑ No►�
If Construction: Retainage Click here to enter text.
If this is a new contractor,please request they complete and submit to Finance a W-9 Form.
Contact Information:
Department Human Resources
Project Manager Logan Project Manager 2792
Phone
Provide a brief description of the contract:
This amendment incorporates the Worksite Wellness Agreement for Valley Health Alliance.No
change in scope or pricing.
Contract Value Summary:
Contract Amount $48,000.00
This Change order/Amendment amount(if applicable) $ 0.00.
New Contract Total $
Procurement Method:
None ® Informal❑ Formal El Sole Source 0 Emergency 0 Contract Renewal 0
Contract Type:
Services/Maintenance El Construction ❑ Goods,Equipment, Supplies ❑
Change Order/Amendment 0 Other,please explain ® Vendor selected by Valley Health Alliance
NOTE: CLERKS OFFICE WILL KEEP ORIGINAL DOCUMENTS IN COMPLIANCE WITH COLORADO STATE
ARCHIVES RETAINAGE SCHEDULE. ALL ATTACHMENTS MUST BE WITH THIS CHECKLIST.
Contract#280.2016 Rev. 8.31.11 jaa/js
Budget Line Item#421.90.00000.82440
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CONTRACT AMENDMENT
Change Order Number:280.2016 A
OWNER: Pitkin County
123 Emma Rd. Suite#106
Basalt,Colorado 81621
CONTRACTOR:
The Provision of Wellness and Administration Services (the "Agreement") dated September 1, 2016
between the Board of County Commissioners of Pitkin County (the "County") and Healthbreak Inc. 601
16th Street, Suite C-311, Golden, CO 80401 (the"Contractor"), is hereby amended as follows:
Description of Change:
Incorporate Exhibit A: Amendment to Worksite Wellness Agreement as part of the Contract documents for
the Provision of Wellness and Administration Services.
Original Contract Price $48,000.00
Net Increase/Decrease in Contract Price(this change order) $0.00
*Total Adjusted Contract Price(including this change order) $
In all other respects the Agreement is in full force and effect and remains unchanged by this Amendment.
•
r,dat ; 10/22/16
ontracto Date
,/11/ /1 / %(
ut •rize T'• er Da e
*Increas• over $25,000 and/or 10% (single increase or accumulative) of original contract must have
County Manager signature.
Rev 12/27/10 js
EXHIBIT A: AMENDMENT TO WORKSITE WELLNESS SERVICES AGREEMENT
This Amendment shall amend the CONTRACT FOR PROVISION OF WELLNESS ADMINISTRATION
SERVICES(hereinafter the"Contract") between Healthbreak,Inc.("Contractor"),and Pitkin County Board
of County Commissioners ("County") originally dated September 1,2016 as follows:
Valley Health Alliance ("VHA") is a not-for-profit organization focused on improving access to quality care,
population health management and reducing waste in the healthcare system ("Health Management
Services"). VHA has partnered with various organizations to provide Health Management Services to its
members. County is a member of VHA and therefore has access to Health Management Services provided
through VHA.
Whole Health LLC is a provider of Health Management Services for VHA and County has entered into a
separate Letter of Agreement("LOA")with Whole Health LLC and its subsidiaries and affiliates for services.
Whole Health LLC will provide health coaching services for the benefit of County and its employees and
spouses.
County has requested that Contractor provide Whole Health LLC with access to individual participant lab
and test results,personal wellness health report and/or access to online medical record in order for Whole
Health to provide health coaching services as agreed to in the LOA.County confirms that it has secured a
Business Associate Agreement("BAA")with Whole Health LLC and agrees to provide a copy to Contractor
upon execution of this Amendment.
Nothing in this Amendment,except as specifically set out herein,is intended to modify,alter,amend or
change the Contract originally dated September 1,2016,between Contractor and County.
By signing below,the parties agree to the Amendment effective this 1st day of October,2016.
Co
By: ir//ad"
Title: C%11i
Healthbreak,Inc.
•
By: '&.L.71�1
Title: President
2