HomeMy WebLinkAboutbocc.res.081.20231
EMERGENCY RESOLUTION OF THE BOARD OF
COUNTY COMMISSIONERS (“BOCC”) OF PITKIN
COUNTY, COLORADO, AUTHORIZING A SNAP
OUTREACH AGREEMENT BETWEEN HUNGER FREE
COLORADO AND PITKIN COUNTY HUMAN
SERVICES
RESOLUTION NO. 081, 2023
RECITALS
WHEREAS, Pursuant to Title 29, Article 1, part 2, Colorado Revised Statutes, as amended
(the “Intergovernmental Relations Statutes”) and Article XIV, Section 18 of the Colorado
Constitution, governments may contract with one another to provide any function, service
or facility lawfully authorized to each of the contracting units and any such contract may
provide for the joint exercise of the function, service or facility, including the establishment
of a separate legal entity to do so, and
WHEREAS, Pursuant to Section 2.8.3 (Actions) of the Pitkin County Home Rule Charter
(“HRC”) official action by formal resolution shall be required for all actions of the Board of
County Commissioners (“BOCC”) not requiring ordinance power on matters of significant
importance affecting citizens, and;
WHEREAS, Pursuant to Section 2.8.5 of the HRC the Board is authorized to approve
emergency resolutions, which shall become effective immediately upon adoption, and;
WHEREAS, accepting the grant funds from Hunger Free Colorado will directly benefit
residents of Pitkin County experiencing food insecurity, and;
WHEREAS, food insecurity is a serious issue and impacts the health and safety of
thousands of residents of Pitkin County each year;
WHEREAS, the BOCC finds that approval of this resolution is necessary for the
immediate preservation of the public health, safety, and welfare of the citizens of Pitkin
County and therefore declares this resolution to be effective immediately pursuant to the
HRC Section 2.8.5.
NOW, THEREFORE, BE IT RESOLVED by the Board of County
Commissioners of Pitkin County, Colorado that it hereby AUTHORIZING
the SNAP Outreach Agreement between Hunger Free Colorado and Pitkin
County Human Services.
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INTRODUCED, READ AND ADOPTED AS AN EMERGENCY RESOLUTION ON
THE 25th DAY OF OCTOBER 2023 AND SET FOR CONFIRMATORY PUBLIC
HEARING ON THE 15th DAY OF NOVEMBER 2023.
NOTICE OF CONFIRMATORY PUBLIC HEARING AND TITLE AND SHORT
SUMMARY OF THE EMERGENCY RESOLUTION PUBLISHED IN THE ASPEN
TIMES WEEKLY ON THE 2ND DAY OF NOVEMBER 2023.
NOTICE OF CONFIRMATORY PUBLIC HEARING AND THE FULL TEXT OF THE
EMERGENCY RESOLUTION POSTED ON THE OFFICIAL PITKIN COUNTY
WEBSITE www.pitkincounty.com ON THE 26TH DAY OF OCTOBER 2023.
CONFIRMED AT A PUBLIC HEARING ON THE 15TH DAY OF NOVEMBER 2023.
POSTED BY TITLE AND SHORT SUMMARY ON THE OFFICIAL PITKIN COUNTY
WEBSITE www.pitkincounty.com ON THE 16TH DAY OF NOVEMBER 2023.
PUBLISHED BY TITLE AND SHORT SUMMARY, AFTER CONFIRMATORY
PUBLIC HEARING, IN THE ASPEN TIMES WEEKLY ON THE 23RD DAY OF NOVEMBER, 2023.
ATTEST: BOARD OF COUNTY COMMISSIONERS
By _________________________ By: _____________________________
Sam Engen Francie Jacober, Chair
Clerk to the Board
Date: ______________
APPROVED AS TO FORM: MANAGER APPROVAL
___________________________ _________________________________
John Ely, County Attorney Jon Peacock, County Manager
Dec-06-2023
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SNAP OUTREACH SUBAWARD AGREEMENT
Between HUNGER FREE COLORADO and THE PITKIN COUNTY BOARD OF COUNTY
COMMISSIONERS ON BEHALF OF PITKIN COUNTY HUMAN SERVICES
For October 1, 2023, to September 30, 2024
This SNAP Outreach SUBAWARD AGREEMENT (“Agreement”) is made on October 1, 2023,
by and between HUNGER FREE COLORADO (“HFC”), a Colorado nonprofit corporation,
having its primary place of business at 1355 South Colorado Blvd, Suite 201, Denver, CO 80222
and THE PITKIN COUNTY BOARD OF COUNTY COMMISSIONERS ON BEHALF OF
PITKIN COUNTY HUMAN SERVICES (PCHS), a Colorado nonprofit corporation having its
primary place of business at 0405 Castle Creek Road, Aspen, CO 81611.
TABLE OF CONTENTS
1. SUBAWARD DATA.......................................................................................................... 2
2. SERVICES PROVIDED BY SUBRECIPIENT. ................................................................ 3
3. TERM OF AGREEMENT .................................................................................................. 3
4. PAYMENT. ........................................................................................................................ 3
5. COMPLIANCE................................................................................................................... 4
6. CLIENT PRIVACY, DATA SECURITY AND DATA GOVERNANCE. ....................... 5
a. Definition of Confidential Data and Personally Identifiable Information (PII). ................ 5
b. Secure PII and Maintain Client Privacy.............................................................................. 6
c. Data Retention. ................................................................................................................... 6
d. Access Restrictions ............................................................................................................. 6
e. Minimally Necessary Principle. .......................................................................................... 6
f. Incidents and Remediation. ................................................................................................. 6
7. REPORTING. ..................................................................................................................... 7
8. INDEPENDENT CONTRACTOR RELATIONSHIP. ...................................................... 8
a. Materials, Equipment and Supplies. ................................................................................... 8
b. Expenses. ............................................................................................................................ 9
c. Contractor's Employees. ..................................................................................................... 9
d. Benefits and Taxes. ............................................................................................................. 9
e. Insurance. ............................................................................................................................ 9
9. EQUAL EMPLOYMENT OPPORTUNTITY. .................................................................. 9
10. INDEMNIFICATION....................................................................................................... 10
11. DISPUTE RESOLUTION. ............................................................................................... 10
12. TERMINATION OF AGREEMENT. .............................................................................. 10
13. SEVERABILITY. ............................................................................................................. 10
14. ENFORECEMENT & WAIVER. .................................................................................... 10
15. NON-DISCLOSURE & CONFIDENTIALITY. .............................................................. 11
16. INTELLECTUAL PROPERTY. ...................................................................................... 11
17. HUNGER FREE COLORADO RESPONSIBLITIES. .................................................... 11
18. TELEPHONIC SIGNATURE COMPLIANCE. .............................................................. 12
19. ENTIRE AGREEMENT, MODIFICATIONS & NOTICE. ............................................ 13
20. APPLICABLE LAW. ....................................................................................................... 13
21. CONTACTS. .................................................................................................................... 14
UPDATED: 09/24/2023
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1. SUBAWARD DATA
(i) Subrecipient Name THE PITKIN COUNTY BOARD OF
COUNTY COMMISSIONERS ON
BEHALF OF PITKIN COUNTY HUMAN
SERVICES
(ii) Subrecipient Unique Entity Identifier: 84-6000794
(iii) Federal Award Identification Number (FAIN): 233CO401S2514
(iv) Federal Award Date of Award to the
Recipient by the Awarding Agency:
October 1, 2023
(v) Subaward Period of Performance Start Date: October 1, 2023
Subaward Period of Performance End Date: September 30, 2024
Subaward Budget Start Date: October 1, 2023
Subaward Budget End Date: September 30, 2024
(vi) Total Award Amount $51,197
(vii) Amount of Federal Funds Obligated by this
Action by HFC to the Subrecipient:
$25,599
(viii) Total Amount of Federal Funds Obligated to
the Subrecipient by the Pass-Through Entity
Including the Current Obligation:
$25,599
(ix) Total Amount of the Federal Award
Committed to the Subrecipient by HFC:
$25,599
(x) Federal Award Project Description: SNAP Outreach
(xi) Name of Federal Awarding Agency: U.S. Department of Agriculture
Name of Pass-Through Entity: Colorado Department of Human Services
Contact Information for CDHS: FEAD Deputy Director
1575 Sherman St., 3rd Floor
Denver, CO 80203
teri.chasten@state.co.us
303.889.9661
Contact Information for HFC Authorizing
Official:
Marc Jacobson
CEO
Hunger Free Colorado
Marc@HungerFreeColorado.org
303.228.7955
UPDATED: 09/24/2023
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(vi) Assistance Listing Number and Name: 10.561 State Administrative Matching
Grants for the Supplemental Nutrition
Assistance Program
2. SERVICES PROVIDED BY SUBRECIPIENT.
PCHS agrees to diligently perform the services described in the SNAP Outreach Project
Proposal approved by the Colorado Department of Human Services (the "Services"
Attachment A) in a timely manner during Agreement Term. PCHS has discretion over
the method, details, and means of performing the Services, and will comply with both
state and federal guidelines regarding SNAP Outreach eligible activities governing the
use of SNAP Outreach funds at all times. PCHS will provide the Services, and may at its
own expense, employ such employees or agents as PCHS deems necessary to perform the
Services provided this is in line with services described in the state-approved SNAP
Outreach Project proposal.
3. TERM OF AGREEMENT
This Agreement is effective October 1, 2023, and will continue in effect until September
30, 2024 (the “Term”), unless terminated earlier by either final completion of the
Services and acceptance of the Services by HFC and the Colorado Department of Human
Services (CDHS), or in accordance with the provisions of Section 11. Pending successful
execution of the services outlined in ATTACHMENT A, it is the intent of CDHS and
HFC to continue supporting this SNAP Outreach partnership with PCHS for additional
years beyond this initial Term, providing continued funding from the United States
Department of Agriculture (USDA) Food and Nutrition Services Division (FNS), the
Colorado Department of Human Services (CDHS) and The Colorado Health Foundation
(TCHF).
4. PAYMENT.
Payment will be made monthly on a reimbursable basis upon completion of the Services
described in ATTACHMENT A and submission of expense reports as described in
Section 6. Upon receipt of the expense report, HFC will include PCHS expenses, based
on actual SNAP Outreach-eligible expenses incurred, in monthly reports to the State of
Colorado for reimbursement in accordance with federal and state rules and guidelines
governing SNAP Outreach and HFC’s SNAP Outreach agreement with the State.
Within 30 days of HFC receipt of reimbursement funds from the State, PCHS will be
reimbursed in the amount that corresponds with the approved expense report. Total
payment will not exceed the budgeted amounts as described in ATTACHMENT A.
Should the Colorado Department of Human Services (CDHS) deem that less than 100%
of the activities and expenditures submitted for any monthly reimbursement request are
non-reimbursable, HFC is not responsible for providing PCHS with funds that make-up
UPDATED: 09/24/2023
4
for the difference in reimbursements requested and received. Only reimbursements
approved by CDHS can be sent to PCHS.
Any item of expenditure by PCHS under the terms of this Agreement which is found by
auditors, investigators, and other authorized representatives of HFC, CDHS, USDA, the
U.S. Government Accountability Office or the Comptroller General of the United States
to be improper, unallowable, in violation of federal or state law or the terms of the Notice
of Prime Award or this Agreement, or involving any fraudulent, deceptive, or misleading
representations or activities of PCHS, shall become PCHS’s liability, to be paid by PCHS
from funds other than those provided by HFC under this Agreement or any other
agreements between HFC and PCHS. This provision shall survive the expiration or
termination of this Agreement.
PCHS shall not be reimbursed or otherwise compensated for any expenditures incurred or
services provided prior to the Effective Date, or following the earlier of the expiration or
termination of this Agreement. HFC shall only reimburse PCHS for documented
expenditures incurred during the Agreement Term that are: (i) reasonable and necessary
to carry out the SNAP Outreach eligible activities; (ii) documented by contracts or other
evidence of liability consistent with established HFC and PCHS procedures; and (iii)
incurred in accordance with all applicable requirements for the expenditure of funds
payable under this Agreement.
5. COMPLIANCE.
PCHS agrees to comply with all relevant Federal, State and Local requirements related to
SNAP Outreach. This includes a BI-ANNUAL SITE VISIT conducted by HFC. It also
includes, but may not be limited to, ensuring all SNAP Outreach workers complete the
following trainings prior to engaging in SNAP Outreach:
• Civil Rights Training
• CBMS Training (if Applicable)
• PEAK Pro Training
• Telephonic Signature Training (if Applicable)
Additionally, all SNAP Outreach workers will sign the Colorado Department of Human
Services Food and Energy Confidentiality Agreement (See ATTACHMENT B) prior to
engaging in SNAP Outreach.
Finally, PCHS must retain all supporting financial documentation used for submitted
Monthly Invoices throughout the grant cycle and for three years thereafter (See Section
6) and make those documents available to HCF or CDHS within two business days.
PCHS shall perform all activities funded by this Agreement in accordance with the (i)
Subaward Data attached hereto as Section 1, including any amendments thereto; (ii) the
Approved Services & Budget attached hereto as Attachment A, including any
amendments thereto; (iii) the applicable contract provisions for non-federal entity
contracts under federal awards required under Appendix II to the Uniform Guidance and
UPDATED: 09/24/2023
5
attached hereto as Attachment F (the “Required Contract Provisions”) (each of (i) – (iii)
above is hereby incorporated by reference into this Agreement). In addition, PCHS shall
cooperate fully with HFC in its efforts to comply with the requirements of the Notice of
Prime Award, including any amendments thereto.
PCHS represents that neither it nor any of its principals has been debarred, suspended or
determined ineligible to participate in federal assistance awards or contracts as defined in
regulations implementing Office of Management and Budget Guidelines on
Governmentwide Debarment and Suspension (Nonprocurement) in Executive Order
12549. Subrecipient further agrees that it will notify HFC immediately if it or any of its
principals is placed on the list of parties excluded from federal procurement or
nonprocurement programs available at www.sam.gov.;
PCHS shall comply with the restrictions on lobbying set forth in Appendix II to Part
200—Contract Provisions for Non-Federal Entity Contracts Under Federal Awards. If the
Subaward exceeds $100,000, PCHS must execute and deliver to HFC the certification
attached hereto as Attachment E (“Certification Regarding Lobbying”).
PCHS shall comply with the requirements of the Drug-Free Workplace Act of 1988, 42
U.S.C. § 701 et seq. and 2 C.F.R. 182, which require all programs and activities receiving
federal assistance to maintain a drug-free workplace.
PCHS shall maintain all records, books, papers and other documents related to its
performance of Approved Services under this Agreement (including without limitation
personnel, property, financial and medical records) for a period of 3 years. Following the
date that HFC makes the last payment to PCHS under this Agreement, or such longer
period as is necessary for the resolution of any litigation, claim, negotiation, audit or
other inquiry involving this Agreement. PCHS shall make all records, books, papers and
other documents that relate to this Agreement available at all reasonable times for
inspection, review and audit by the authorized representatives of HFC, CDHS, USDA,
the U.S. Government Accountability Office and the Comptroller General of the United
States.
6. CLIENT PRIVACY, DATA SECURITY AND DATA GOVERNANCE.
In the execution of this agreement, PCHS will collect and receive Personally Identifiable
Information (PII) which must be kept confidential. PCHS agrees to take all reasonable steps
to ensure confidentiality of PII and to protect these data as defined below.
a. Definition of Confidential Data and Personally Identifiable Information
(PII).
In the execution of this agreement, PCHS will collect and receive Personally Identifiable
Information (PII) which must be kept confidential. PII is any data that could potentially
identify a specific individual and includes, but is not limited to:
i. Name
ii. Date of Birth
UPDATED: 09/24/2023
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iii. Social Security Number
iv. Other unique IDs
v. Personally Identifiable Financial Information
vi. Medical Information
vii. Health Information
viii. Any other data that could potentially be used to identify a specific
individual
If PCHS is unsure whether a class of data is considered PII and must therefore be kept
confidential, it will act as though these data are PII until it has expressed written
confirmation from HFC that those data are not covered.
b. Secure PII and Maintain Client Privacy.
PCHS will take all reasonable steps to ensure client information is secure and
confidential. This includes ensuring PII is secured such that physical documents are
locked when not in use and digital documents are password protected. It also requires
ensuring PII is not left unattended and visible on either a desk or on a desktop such that it
can be viewed by unauthorized individuals. Finally, it mandates that data are disposed of
properly including shredding of PII stored on paper.
c. Data Retention.
Upon completion or termination of this agreement, PCHS will dispose of all PII and will
not maintain PII beyond the term of this agreement. Disposal should protect the
information, including shredding any hard copies and deletion of all electronic copies,
including within archived data sets.
d. Access Restrictions
PCHS will limit access to PII attained as part of this contract to only those staff engaged
in SNAP Outreach, who have completed all trainings identified in Section 4 and who
have signed a confidentiality agreement (see Attachment B). Staff who have not
completed trainings and/or not signed a confidentiality agreement shall not have access to
any PII attained as part of this agreement.
e. Minimally Necessary Principle.
PCHS will limit the use of PII to that which is minimally necessary to complete the work
associated with this agreement. This implies that as part of this agreement, PCHS will not
collect PII unless it is necessary for SNAP Outreach or to meet the obligations contained
herein.
f. Incidents and Remediation.
PCHS agrees to make a good faith effort to identify any use or disclosure of confidential
data not authorized by this Agreement. If PCHS becomes aware of any inappropriate
UPDATED: 09/24/2023
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release, disclosure, or breach of Sensitive Data, it will notify HFC within 24 hours and
will cooperate regarding recovery, mitigation, remediation, and any necessary actions to
comply with state and federal law. Additionally, PCHS may not contact impacted
individuals until HFC and PCHS have agreed upon a remediation plan in partnership with
any necessary government agencies. Finally, following an incident, PCHS will work with
HFC to reduce the risk of future breeches.
7. REPORTING.
PCHS agrees to provide reports on both the substance of SNAP Outreach activities and
itemized expenses reports for inclusion to the Colorado Department of Human Services
(CDHS) for monthly reimbursements. This includes the following reports:
• Monthly Activities Report. By the 5th of each month, PCHS will provide HFC
the total number of SNAP Applications, Change Reports and Redeterminations
for the prior month. The data are due by the 5th even if the 5th is a weekend,
though PCHS may always submit the report early.
Additionally, by the 15th of each month, PCHS will provide HFC data via the
Monthly Activities Report (template provided by HFC). The report is due by the
5th even if the 5th is a weekend, though PCHS may always submit the report
early. At a minimum this report will include:
o Number of SNAP Applications, Change Reports and Redeterminations for
households with people over 60 years old in the month
o Number of touch points with clients:
▪ Events attended/hosted (if applicable)
▪ Total number of people engaged around SNAP Outreach (if
applicable)
▪ Brief narrative (roughly 1 paragraph) account of
challenges/barriers encountered with SNAP Outreach efforts
▪ Brief narrative (roughly 1 paragraph) describing any necessary
supports that HFC, the State, counties or other entities may be able
to provide to improve SNAP Outreach efforts
▪ 1 to 2 stories to share of clients about how SNAP impacts their
lives
• Annual Activities Report. No later than October 9th, 2023, PCHS will provide
HFC data via the Annual Activities Report for all work completed to-date
(template provided by HFC), which will mirror the Monthly Activities Report in
content. This aligns with the federal fiscal year (October 1st to September 30th)
and is necessary for federal reporting.
• Monthly Invoices. PCHS shall ensure that expenses submitted as part of these
invoices are exclusive to SNAP Outreach activities and shall not include work or
activities performed for other programs. If PCHS staff provide multiple services
UPDATED: 09/24/2023
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in the course of their work, they must delineate the portion of work for SNAP
Outreach activities via a time reporting process.
Invoices for this agreement will be due by the 20th month. Invoices must, at a minimum,
include:
o Itemized Expenses - Itemized documentation of actual expenses for
SNAP-eligible activities using the billing templated provided by HFC and
CDHS.
o Time Reporting - Time reports for each staff involved in the project and
payroll reports, such as a payroll register detailing payroll and benefits
paid. HFC will provide a template for this reporting, which must be
signed by supervisory staff.
Expenses not included by the 20th of the month may be added to the following month’s
Invoice. Incomplete invoices shall be returned to PCHS without payment and may be
added to the following month if finalized following the 20th of the month.
However, to align with the federal fiscal year, ALL expenses through September 30th,
2024, MUST be invoiced by October 30th, 2024, or 30 days after the termination of the
agreement, whichever occurs first. This invoice shall be marked FINAL, and no
additional payments may be made for work done prior to September 30th after the
October 2024 invoice has been submitted. All expenses incurred after September 30th,
2024, must be invoiced by October 30th, 2024.
8. INDEPENDENT CONTRACTOR RELATIONSHIP.
PCHS and HFC understand and agree that PCHS’s relationship to HFC is that of an
independent contractor, and nothing in this Agreement creates a joint venture,
partnership, or employer-employee relationship. Accordingly, PCHS and its employees
and agents, if any, are not entitled to any benefits that may ordinarily be extended to
employees of HFC, and PCHS and its employees and agents and are not authorized to
make any representation, contract or commitment on behalf of HFC unless specifically
authorized to do so by HFC. During the Term of this Agreement, PCHS is free to provide
services to any other organizations.
a. Materials, Equipment and Supplies.
PCHS will furnish and cover the up-front cost of materials and equipment necessary to
perform the Services, such as computer hardware and software, desk telephone, office
furniture, office equipment such as printer, copier, fax machine, as well as office
supplies. HFC will reimburse PCHS for only those materials, equipment and supplies
itemized in PCHS’s proposed budget and budget narrative, which were approved
expenses by the Colorado Department of Human Services (CDHS).
UPDATED: 09/24/2023
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b. Expenses.
PCHS is responsible for all reasonable business expenses associated with providing the
Services as described in ATTACHMENT A. HFC will reimburse reasonable expenses
outlined in the approved budget including mileage reimbursement at the current federal
mileage reimbursement rate and other pre-approved travel expenses. Federal mileage
reimbursement is often adjusted each year on January 1, therefore, the mileage rate for
this agreement may change on October 1, 2023, and the approved budget will adjust
accordingly.
c. Contractor's Employees.
HFC may not control, direct, or supervise PCHS’s employees in the performance of the
Services described in ATTACHMENT A. HFC will provide training and technical
assistance related to SNAP Outreach as described in Section 16 and PCHS may seek
further guidance from HFC regarding training, invoicing, organizational relationships or
technical concerns.
d. Benefits and Taxes.
PCHS is solely responsible for payment of all federal, state, and local income and payroll
taxes with respect to compensation received under this Agreement. HFC has no
responsibility for the withholding or payment of federal, state or local taxes, for
withholding or contributions under the federal insurance contributions act (FICA), or for
contributions under the federal unemployment tax act (FUTA) on behalf of PCHS or its
employees in connection with the Services.
e. Insurance.
HFC will not provide or procure insurance, including health, life, dental or vision
insurance, workers’ compensation, unemployment, or liability insurance, on behalf of
PCHS or its employees. Throughout the Term of this Agreement, PCHS will maintain its
own workers compensation insurance, unemployment insurance and automobile
insurance in the amounts required by statute. At HFC’s request, PCHS will provide
certificates or other acceptable evidence of insurance evidencing the foregoing coverage
and will provide HFC with prompt written notice of any material change to the same.
9. EQUAL EMPLOYMENT OPPORTUNTITY.
PCHS shall not discriminate against any employee or participant because of age, sexual
orientation, gender, marital status, physical or mental disability, race, color, national
origin, military status, religion, or any other protected class. PCHS will take affirmative
action to ensure that employees and participants are treated without regard to their age,
sexual orientation, gender, marital status, physical or mental disability, race, color,
national origin, military status, religion, or any other protected status.
UPDATED: 09/24/2023
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10. INDEMNIFICATION.
PCHS agrees to indemnify and hold harmless HFC and its officers, directors, agents and
employees (each a “Covered Party”) from and against any and all liabilities, losses,
claims, damages, judgments, costs, expenses, obligations, penalties including interest and
attorney fees that it shall incur or suffer that arise out of, result from, or relate to PCHS’s
activities pursuant to this Agreement.
Further, HFC agrees to indemnify and hold harmless PCHS and its officers, directors,
agents and employees (each a “Covered Party”) from and against any and all liabilities,
losses, claims, damages, judgments, costs, expenses, obligations, penalties including
interest and attorney fees that it shall incur or suffer that arise out of, result from, or relate
to HFC’s activities pursuant to this Agreement.
11. DISPUTE RESOLUTION.
HFC and PCHS agree that, in the event a dispute arises between them concerning this
Agreement, HFC and PCHS will submit the dispute to binding arbitration according to
the rules of the American Arbitration Association. Any such arbitration shall be
conducted in Denver, Colorado. Each party shall be solely responsible for its legal
expenses associated with such arbitration and any subsequent proceedings.
12. TERMINATION OF AGREEMENT.
Should either party wish to terminate this Agreement for material breach, the terminating
party will provide the other party at least thirty (30) days’ written notice of and the
opportunity to cure the breach. Before terminating the Agreement, CDHS must first be
notified and given fifteen (15) days to respond. Termination for breach will not preclude
the terminating party from exercising any other remedies for breach.
13. SEVERABILITY.
If any of the provisions of this Agreement are held invalid or unenforceable, such
invalidity/unenforceability will not invalidate or render unenforceable the entire
Agreement, rather the entire Agreement will be construed as if not containing the
particular invalid or unenforceable provision(s); the rights and obligations of the parties
will be construed and enforced accordingly to effectuate the intent and purposes of this
Agreement.
14. ENFORECEMENT & WAIVER.
The failure of either party in any instance to insist upon strict performance of any of the
terms and provisions of this Agreement shall not be construed as a waiver of the right to
assert any such terms and provisions on any future occasion or of damages caused
thereby.
UPDATED: 09/24/2023
11
15. NON-DISCLOSURE & CONFIDENTIALITY.
In the course of performing the Services described in ATTACHMENT A, PCHS, HFC
and their employees and agents may have access to documents, data or other information
(which may be in the form of printed materials, electronic data, oral statements or other
formats), which is confidential and proprietary in nature.
Each party and its employees and agents will not, either during or after the Term of this
Agreement, directly or indirectly publish or otherwise disclose to any third party, or use
for personal gain, any confidential information without the prior written consent of the
other party. If either PCHS or HFC is uncertain about whether a specific document or
piece of information is considered confidential, PCHS will consult with the other party.
Each party will ensure that all confidential information is stored securely and shared only
with the other party and certain third parties approved by each party. PCHS and HFC and
their employees and agents will keep confidential any computer security passwords
received during the term of this agreement and will not share such passwords with any
other person. Upon termination of this Agreement, any confidential information obtained
by PCHS or HFC or their employees or agents will promptly be returned to the other
party.
Additionally, all SNAP Outreach workers will sign the Colorado Department of Human
Services Food and Energy Confidentiality Agreement (See ATTACHMENT B) prior to
engaging in SNAP Outreach.
16. INTELLECTUAL PROPERTY.
Each party represents and warrants that all material or content, regardless of the media in
which it is submitted (“work product”), provided by either party to the other party will be
original works or that it has the right to grant the other party the rights in the work
product granted by this Agreement Each party also represents and warrants that the work
product does not infringe any copyright, trademark, trade secret or other proprietary,
contractual or personal right of another. PCHS Each party will ensure that the work
product contains facts and statements that are true and accurate. HFC has the right to use
PCHS’s name, by-line, photograph, likeness, or biographical material in connection with
the use, publication or republication of the work product resulting from this Agreement.
HFC also has the right to edit and prepare derivative works of the work product with
PCHS’s prior written consent, which will not be unreasonably withheld.
17. HUNGER FREE COLORADO RESPONSIBLITIES.
HFC agrees to provide PCHS with:
• SNAP Outreach Training – HFC will train PCHS SNAP Outreach staff on all
necessary aspects of SNAP Outreach. This includes:
i.Compliance trainings including Civil Rights Training
ii.Technical training on the use of PEAK Pro, CBMS, and telephonic
signature
iii.SNAP eligibility and benefits
UPDATED: 09/24/2023
12
• Software Licenses – via the Colorado Department of Human Services, HFC will
provide PCHS SNAP Outreach staff with PEAK Pro licenses and will
provide one read-only CBMS license for PCHS. HFC will also provide licenses
for GoToMeeting or an approved alternative for use as part of the telephonic
signature.
• Telephonic Signature Storage and Retrieval – HFC will provide a secure
upload feature via Form Assembly for PCHS to upload telephonic signatures for
storage and retrieval. As part of this service, HFC will be responsible for the secure
storage of all telephonic signatures provided by PCHS for a period of five years.
• Technical Assistance – In partnership with the Office of Information Technology
(OIT), HFC will provide technical assistance for PEAK Pro and CBMS
• Evaluation and Data – HFC will provide PCHS with support in analyzing data
and understanding how PCHS SNAP Outreach efforts fit within the larger SNAP
Outreach picture in Colorado.
• Relationship Support – HFC will support PCHS with building and maintaining
relationships with county Human Service Departments, other SNAP Outreach
partners, the Colorado Department of Human Services and other entities related to
SNAP Outreach.
18. TELEPHONIC SIGNATURE COMPLIANCE.
PCHS may complete SNAP Applications in person or telephonically. As part of accepting
and recording telephonic signatures, PCHS will ensure it:
• Records Signatures – PCHS will record telephonic signatures, or recordings of
clients granting their permission to submit an application on their behalf. These
signatures will include responses to all of the CDHS approved assent questions.
• Saves Signatures – PCHS will save recordings and will associate them with
individual client records, using an approved HIPPA-compliant method. Recordings
will be saved in accordance with current naming conventions.
• Send Signatures to HFC – PCHS will send all telephonic signatures
to HFC using the Form Assemble Portal or other approved secure file transfer
protocol.
• State Review – PCHS will provide MP3, MP4 or WAV files of these recordings
within two business days of a request from HFC or the Colorado Department of
Human Services. PCHS will also comply with all audits and reviews of the telephonic
signature process, by either HFC or CDHS.
• Follows-up with Printed Materials – PCHS will mail a copy of the authorized
letter and a printed copy of the application to the client for all applications processed.
• Provides Clients with Mail Option – PCHS will provide clients with the option
to do the application via mail and hard copy and will track clients exercising this
option, including their name, the date of the call and the date of the follow-up action.
• Remedies Technical Failures – in the event of a technical failure rendering a
telephonic signature unusable, PCHS contacts the applicant and attempts to obtain a
new telephonic signature.
• Reports Discrepancies – PCHS will contact the appropriate county Department
of Human Services to report application discrepancies.
UPDATED: 09/24/2023
13
Additionally, PCHS will ensure all staff utilizing telephonic signature will comply with the
following:
• Attain Agreement for Telephonic Assistance – staff will ensure applicants
agree to telephonic assistance prior to starting an application by phone.
• Notify When Recording – staff will notify applicants when they are recording
the conversation.
• Proficiency Reading and Explaining Requirements – staff will be proficient at
reading the Rights and Responsibilities and the Verbal Assent Statement. If an
applicant does not understand either of these, staff will provide further clarification.
• Follow-up – After completing an application, staff will mail the applicant both
the approved letter and a hard copy of the application. These materials should include
the applicants’ next steps, documents necessary for verification, and how to
contact PCHS should issues arise.
19. ENTIRE AGREEMENT, MODIFICATIONS & NOTICE.
This Agreement constitutes the entire agreement and understanding between the parties
with respect to the subject matter hereof and supersedes all prior agreements and
understandings. Any modification to this Agreement, including Attachment(s), must be
in writing, signed by HFC and PCHS and should the modification relate to the
expectations as laid out in ATTACHMENT A, the Colorado Department of Human
Services (CDHS) must be notified and given fifteen (15) days to respond. Notice shall be
deemed given when delivered by hand or by a courier service, or when deposited in the
US Mail, first class postage affixed, addressed to the party to be notified at the address
provided herein, or such other address as may be given by notice.
20. APPLICABLE LAW.
PCHS shall perform all activities funded by this Agreement in accordance with all
applicable federal, state and local laws. The term “federal, state and local laws” as used
in this Agreement shall mean all applicable statutes, rules, regulations, executive orders,
directives or other laws, including all laws as presently in effect and as may be amended
or otherwise altered during the Agreement Term, as well as all such laws which may be
enacted or otherwise become effective during the Agreement Term. The term “federal,
state and local laws” shall include Uniform Administrative Requirements, Cost
Principles, and Audit Requirements, 2 C.F.R. Part 200.
UPDATED: 09/24/2023
14
21. CONTACTS.
The contact information for HFC and PCHS are as follows:
For HUNGER FREE COLORADO:
Elissa Hardy
Director of Client Services
Hunger Free Colorado
720.750.7125
Elissa@HungerFreeColorado.org
For THE PITKIN COUNTY BOARD OF COUNTY COMMISSIONERS ON BEHALF
OF PITKIN COUNTY HUMAN SERVICES:
Matt McGaugh
Deputy Director of Programs and Services
Pitkin County Department of Human Services
970.618.5780
matt.mcgaugh@pitkincounty.com
PCHS agrees to maintain a contact for HFC for SNAP Outreach and to notify HFC of any
changes to this contact within 10 business days of the change.
UPDATED: 09/24/2023
15
HUNGER FREE COLORADO
Signature: _________________________________
Name: ____________________________________
Title: ____________________________________
Date: ____________________________________
THE PITKIN COUNTY BOARD OF COUNTY
COMMISSIONERS ON BEHALF OF PITKIN
COUNTY HUMAN SERVICES
Signature: _________________________________
Name: ____________________________________
Title:____________________________________
Date: ____________________________________
Pitkin County Commissioner
Francie Jacober
Oct-25-2023
16
ATTACHMENT A: SUBRECIPIENT SERVICES & BUDGET
For THE PITKIN COUNTY BOARD OF COUNTY COMMISSIONERS ON BEHALF OF
PITKIN COUNTY HUMAN SERVICES (PCHS) SNAP Outreach FFY 2023-2024
GOAL: 360 SNAP Applications by 10/1/2024 – 108 by 3/15/2024
Increase capacity for food-insecure residents of the Pitkin County region to connect to food
resources by providing SNAP outreach and application assistance. In FFY 2023-2024 PCHS
goal is to submit 360 SNAP Applications by September 30, 2024. As a milestone, PCHS aims
to have submitted 108 SNAP Applications by March 15, 2024 (30% of the annual goal within
the first five months). If PCHS does not meet this milestone, HFC and PCHS will jointly revisit
the plan and budget and make any necessary adjustments.
DESCRIPTION OF SUBRECIPIENT SERVICES
This project reimburses Pitkin County's Benefits Outreach Specialists to increase the County's
capacity around SNAP outreach and enrollment. When face-to-face contact is allowed, these
workers are primarily stationed out in the community, in various locations throughout Pitkin
County, providing direct SNAP application assistance where clients in need are located. When
social distancing does not allow for face-to-face services, these workers follow up with clients to
process change reports and redeterminations and to complete applications which came in without
sufficient information to determine eligibility. All activities include services and supports
provided in Spanish as well as English.
UPDATED: 09/24/2023
17
BUDGET
The total budget for this work is $51,197 as shown below.
Table 1. Budget
Over the course of this project, total reimbursement will not exceed $51,197 in allowable costs
and will not exceed $8,533 until amended to reflect the total budget amount of $51,197 (SEE
TEMPORARY NOT TO EXCEED LEVEL below). Throughout the course of the Term, PCHS
may shift money across line items, but not by more than 20% of each line without prior
written consent by HFC.
EXPENSES Other Non-Federal Federal Match TOTAL FUNDS
(g) Personnel (Salary and Benefits)25,206$ 25,206$ 50,411$
Other Direct Costs
(h) Copying/Printing/Materials -$ -$ -$
(i) Internet/Telephone -$ -$ -$
(j) Equipment and Other Capital Expenditures -$ -$ -$
(k) Supplies and Non Capital Expenditures -$ -$ -$
(l) Building/Space -$ -$ -$
(m) Other -$ -$ -$
(n=h+i+j+k+l+m) Subtotal Other Direct Costs -$ -$ -$
Travel
(o) Long Distance -$ -$ -$
(p) Local 393$ 393$ 786$
(q=o+p) Subtotal Travel 393$ 393$ 786$
(r) Contractual -$ -$ -$
(s=g+n+q+r) Total Personnel, Direct Costs, Travel,
and Contractual 25,599$ 25,599$ 51,197$
(t = indirect cost rate X r) Indirect Costs -$ -$ -$
(u=s+t) TOTAL 25,599$ 25,599$ 51,197$
UPDATED: 09/24/2023
18
The table below provides further detail on each line item.
Table 2. Budget Detail
(g) Personnel Deputy Director of Programs/Services 0.03 FTE: $4,644
• $3,870 is 0.03 FTE @ Salary of $129,000
• $774 is 20% Benefits
Accounting Analyst III 0.03 FTE: $3,121
• $2,601 is 0.03 FTE @ Salary of $86,686
• $520 is 20% Benefits
Eligibility & Outreach Specialist 0.211 FTE: $16,050
• $13,375 is 0.211 FTE @ Salary of $63,391
• $2,675 is 20% Benefits
Benefits Outreach Specialist 0.25 FTE: $23,960
• $19,967 is 0.25 FTE @ Salary of $79,868
• $3,993 is 20% Benefits
Program Analyst 0.03 FTE: $2,636
• $2,196 is 0.03 FTE @ Salary of $73,216
• $440 is 20% Benefits
TOTAL PERSONNEL: $50,411 (p) Local Travel Local Travel: $786 - about 100 mi/week (1,200 mi*$0.655/mile)
Total $51,197
TEMPORARY NOT TO EXCEED LEVEL: $8,533 (17% of the total - 2 months funds)
The full approved funding level will not be available upon the start date for this contract. As
such, while the total budget for this project remains $51,197 reimbursement will not
exceed $8,533 until all funds are available and this contract is amended to reflect a lifting of this
cap. HFC and CDHS expect this will occur by or before November 30, 2023, and will continue
to communicate THE PITKIN COUNTY BOARD OF COUNTY COMMISSIONERS ON
BEHALF OF PITKIN COUNTY HUMAN SERVICES should this change.
UPDATED: 09/24/2023
19
ATTACHMENT B: FOOD AND ENERGY CONFIDENTIALY
AGREEMENT
Division of Food and Energy Assistance
Confidentiality Agreement
I, , understand that in the course of my employment or contract
with the State of Colorado, its offices, agencies and/or departments either by direct contract or
through agreements between State offices, agencies or departments I may receive or become
aware of business or personnel information that is sensitive and/or confidential and not available
to the general public.
This information may be written, electronic, or verbal and come from a variety of sources. I
understand that this information may be subject to special protections under State or Federal laws
or polices of the State office, agency, or department. I understand that I am not to intentionally
access sensitive or confidential information unless it is necessary in order for me to complete my
job responsibilities and if so, such necessity will be set out in a statement of work regarding the
specific project I am working on.
I acknowledge that I have an affirmative responsibility to protect all sensitive or confidential
information I become aware of during the course of my duties. I further understand that this
obligation does not apply to information I may become aware of that is available to the general
public, through common knowledge or internet search.
I understand that in the performance of my duties I may be requested to provide sensitive or
confidential information to others. I agree to hold in confidence and to not disclose any sensitive
or confidential information to any person, including employees of state, federal or local
governments including law enforcement, except to those who have an official business reason for
the information. Should I have any questions regarding the proper handling or disclosure of
confidential or sensitive information, I will immediately notify my supervisor or manager and/or
the supervisor or manager of the project I am working on for further clarification and direction
prior to releasing any information.
If I willfully and knowingly disclose such information in any manner to any person or agency not
entitled to receive the information, I understand that I may be subject to adverse action, including
corrective or disciplinary action, dismissal or personal liability depending on the severity of my
actions and applicable law. It is my duty and responsibility to return all State information and not
to retain any copies, in any format upon the completion of my employment or contract.
I acknowledge that I have read, understand, and will adhere to the above requirements with
respect to sensitive and/or confidential information.
Signature: .
Printed name: .
Date: .
Data Recipient should maintain a copy of the executed form and provide it upon request
UPDATED: 09/24/2023
20
ATTACHMENT C: TELEPHONIC SIGNATURE
ORGANIZATIONAL AGREEMENT
Telephonic Signature Policy
Updated August 8, 2021
The Colorado Department of Human Services’ (CDHS) Supplemental Nutrition
Assistance Program (SNAP), also known as Food Assistance, works closely with our
Outreach partners to provide food security to eligible Coloradans. In order to provide
streamlined application assistance, telephonic signatures, defined as verbal assent for
application assistance and submission, are a helpful step to assist individuals in the
community connect to SNAP.
Below is the outline of Colorado’s telephonic signature policy to which all Colorado
SNAP Outreach Vendors must comply.
Accepting a Telephonic Application
1. Each SNAP Outreach vendor employs highly trained customer service representatives.
2. After educating the client about the benefit(s) they may be able to receive, the representative
informs the client of the various methods in which they can apply for SNAP. These methods
include via PEAK, in-person at a county office, SNAP Outreach vendor location, by
telephone with the SNAP Outreach vendor, or paper application through postal mail, email,
or fax.
3. If the client would like to complete the telephonic application, the representative should
explain to the client that the information collected is entered into the PEAK online
application system. It is recommended that SNAP Outreach vendors build processes around
asking all questions on the PEAK application form.
4. Representative will explain to clients who are completing a SNAP telephonic application that
they may need to still complete an eligibility interview with a county representative and may
be asked similar questions to confirm the information sent to the county office by the SNAP
Outreach vendor.
5. For clients who would like other ways to complete the application, SNAP outreach vendor must
provide client with additional ways to complete the application (e.g., paper, electronic application
etc.) and document this effort. Paper applications need to be mailed within 3 days and electronic
applications need to be emailed immediately.
6. Telephonically submitted applications must have a marker to notate the application was
completed using a telephonic signature.
a. In the application signature name field, each SNAP Outreach vendor using
telephonic signature will put their organization’s PCHS+tel after the applicant’s last
name.
UPDATED: 09/24/2023
21
Voice Signatures
1. SNAP Outreach vendors must record the verbal assent from the client regarding a
summary of the information provided to them, and the date of the telephonic signature
recording. SNAP Outreach vendors may elect, but are not required, to record the entire
telephone conversation.
2. All callers are notified that their verbal assent of the summary of the information shared
with them is being recorded. If the entire conversation is being recorded, callers must be
informed of this at the beginning of the conversation.
3. The client’s verbal assent must be captured in their preferred language.
a. If a client requests or requires an interpreter in their preferred language, vendors
must assist them with their language needs. Verbal assent may be captured with
assistance of the interpreter. Please refer to “Bilingual service requirements” if
unable to assist a client with their language needs.
b. If a client is deaf or hard of hearing and utilizes a sign language interpreter,
vendors may record the telephonic signature with an interpreter verbally
translating or via video with an interpreter to capture assent. Video recordings are
subject to the same compliance and monitoring requirements outlined in this
policy.
4. SNAP Outreach vendors must confirm and capture the client’s full name as part of the
telephonic signature.
5. All telephone conversations where a SNAP application is completed must include the
reading of CDHS approved statements attesting to the accuracy of information. The
applicant must agree to these statements in order to have the application submitted. The
following statements must be read as part of the assent:
a. I confirm that my household is applying for SNAP benefits.
b. I understand the questions and statements on this application.
c. I affirm under penalty of perjury that the information I provided is true, to the best
of my knowledge, including information concerning citizenship and non-citizen
status.
d. I confirm the identity of each applicant and will/have provided their correct name,
date of birth and social security number.
e. I understand that I will be provided a summary of the information collected
during this application and a copy of the Rights and Responsibilities to keep for
my records. I will read through the document and report any errors, changes, or
questions.
6. SNAP Outreach vendor representatives complete telephonic SNAP applications with the
client and submit them through Colorado PEAK.
UPDATED: 09/24/2023
22
Records and Storage
1. Recordings must be made and stored in WAV or MP3 or MP4 format, as these formats can
be easily submitted to and accessed for review.
2. If recorded in WAV format, the recording should be transferred to MP3 or MP4. SNAP
Outreach vendors must transmit the telephonic files to the Agency when requested.
3. Recordings must be transmitted and protected in accordance with the high-security
parameters including password protected login, archive encryption, and standard computer
security software.
4. All recordings must remain accessible and retrievable for five years after the recording date.
Recordings may be required to be kept longer if the case is under review for IPV or other
client error. Recordings will be appropriately backed-up to ensure that they are protected
while being stored.
a. CDHS will conduct a review of the backup process of all SNAP Outreach vendors
using electronic signatures to validate security and process. Should the Agency
experience a data failure or a problem with electronic submission to CDHS,
vendors will be able to provide the CDHS with a replacement copy of the
recording.
5. Should the agreement between the SNAP Outreach vendor and CDHS be terminated, the
vendor will transfer all telephonic signature recordings to CDHS within 30 days.
Monitoring and Compliance
1. In order to verify compliance, telephonic signatures should be sampled and reviewed on a
regular basis to ensure that the preceding criteria are met. This is currently done on a
monthly basis by reviewing SNAP Outreach vendors’ telephonic signatures from the
month prior.
2. An Excel sheet of all SNAP Outreach applications (Name, PEAK Tracking #, Date, etc.)
completed with a telephonic signature for the previous month should be uploaded to the
SNAP Outreach Telephonic Signatures Google Drive.
a. Please upload to the appropriate vendor folder and month and year.
b. The Excel sheet of applications must be uploaded by the 10th of the month, or the
next working day.
3. Five random applications will be selected. Within a week, CDHS will notify vendors via
encrypted email of the selected files to upload. Vendors must upload the selected five
audio files to the appropriate vendor folder in the Google Drive.
a. Audio files must be uploaded by the 20th of the month, or the next working day.
4. Notify cdhs_snap_outreacheducation@state.co.us after any document(s) has been
uploaded to the Google Drive.
a. If a vendor has an extenuating circumstance and cannot meet the deadline, please
notify this email as soon as possible.
UPDATED: 09/24/2023
23
5. CDHS will notify vendors of any recommendations or findings and will proceed with
further instructions.
Confirmations and Receipt
1. Once a telephonic application is successfully completed, a copy of the application will be
printed from PEAK. This application will be sent promptly to the applicant for confirmation
and review. First class postal mail is the preferred method of delivery.
2. To prevent loss of SNAP benefits to the applicant or application processing delays, CDHS
encourages SNAP Outreach vendors to submit the application electronically via PEAK on
the same day the telephonic signature is received.
3. Along with a copy of the submitted application, the SNAP Outreach vendor will include a
CDHS approved cover letter which includes the following information:
a. Instructions on how to correct application inaccuracies with the SNAP Outreach
vendor or the appropriate county SNAP office
b. Next steps in the application process including instructions on how to complete the
SNAP interview
c. Contact information for the SNAP Outreach vendor
d. Contact information for the appropriate county SNAP office
e. Additional information on requested documentation for expedited eligible households
and households not requesting document assistance from the vendor
4. SNAP Outreach vendors will keep a record of the client’s request to amend any application
inaccuracies, including the date and time of the request.
5. SNAP Outreach vendors will keep a record of any effort that staff makes to contact a county
office to report an application discrepancy and will include this information in the client’s
summary file should CDHS request it for an administrative hearing, audit, or other oversight
purposes.
Bilingual service requirements
1. SNAP Outreach vendors may employ in-house staff who speak other languages.
a. If unable to assist a client with their language needs, the SNAP Outreach vendor will
discontinue the telephonic application process and will connect an individual to the
appropriate county SNAP office.
2. SNAP Outreach vendors will record an applicant’s preferred spoken and written language
as part of the application.
Signature:_________________________________Date:__________________
UPDATED: 09/24/2023
24
ATTACHMENT D: TELEPHONIC SIGNATURE USER
AGREEMENT
Telephonic Signature Policy
Required Training Elements of the Outreach Workers
Please initial next to each statement and then sign and date this form. It is the responsibility of THE
PITKIN COUNTY BOARD OF COUNTY COMMISSIONERS ON BEHALF OF PITKIN
COUNTY HUMAN SERVICES to maintain a signed copy of this form on file to ensure they are in
compliance with the process agreed to by the parities
___ I understand that before starting an application by phone, the client must agree to
telephonic assistance.
___ If the client requests a paper application to be mailed to them instead of telephonic
assistance, I understand that I will provide the copy within twenty-four hours and inform
the client of other ways of applying.
___ I am comfortable reading the CDHS Telephonic Signature Assent statements. If a
person asks me to explain this in more simplistic terms, I understand how to do this.
___ I understand that I must notify the client that a county worker may be contacting
them for an eligibility interview and may request additional information in order to
determine the client’s eligibility for Food Assistance.
___ I understand that I must notify the client that I am recording their verbal assent
statements which will include their confirmation of understanding.
___I understand that I must confirm the identity of the applicant by asking for their full
name.
___ I understand that all recordings must include the following application elements: a
confirmation of the identity of the applicant, CDHS Telephonic Signature Assent
statements and the date the application was signed.
___ I understand how to start, record, and save telephonic signatures.
___If there is a system failure of the recording, I understand my responsibilities to correct
this by notifying the client immediately and re-record their verbal assent.
UPDATED: 09/24/2023
25
___ I understand how to add my ORGANIZATION’s PCHS plus the word “tel” after a
client's last name in the signature field of the PEAK application. (e.g., PCHStel)
___ I understand that after each telephonic signature application, I must promptly send to
the client a printed copy of the submitted PEAK application with a letter outlining next
steps, how to correct anything wrong in the application, and county contact information.
In the case that the individual does not have a mailing address, the client is able to use
General Delivery as a substitute.
___ I understand how to explain to a client how to correct errors contained in their
application.
Employee Signature ____________________________ Date: ______________
Last updated 4/2020
UPDATED: 09/24/2023
26
ATTACHMENT E: CERTIFICATION REGARDING LOBBYING
Certification for Contracts, Grants, Loans, and Cooperative Agreements.
The undersigned, on behalf of agency, certifies, to the best of his or her knowledge and
belief, that:
1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person for influencing or attempting to influence an officer or
employee of an agency, a Member of Congress, an officer or employee of Congress, or
an employee of a Member of Congress in connection with the awarding of any Federal
contract, the making of any Federal grant, the making of any Federal loan, the entering
into of any cooperative agreement, and the extension, continuation, renewal, amendment,
or modification of any Federal contract, grant, loan, or cooperative agreement.
2. If any funds other than Federal appropriated funds have been paid or will be paid to any
person for influencing or attempting to influence an officer or employee of any agency, a
Member of Congress, an officer or employee of Congress, or an employee of a Member
of Congress in connection with this Federal contract, grant, loan, or cooperative
agreement, the undersigned shall complete and submit Standard Form-LLL, “Disclosure
Form to Report Lobbying,” in accordance with its instructions.
3. The undersigned shall require that the language of this certification be included in the
award documents for all subawards at all tiers (including subcontracts, subgrants, and
contracts under grants, loans, and cooperative agreements) and that all subrecipients shall
certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this
transaction was made or entered into. Submission of this certification is a prerequisite for making
or entering into this transaction imposed by section 1352, title 31, U.S. Code. Any person who
fails to file the required certification shall be subject to a civil penalty of not less than $10,000
and not more than $100,000 for each such failure.
THE PITKIN COUNTY BOARD OF COUNTY COMMISSIONERS ON BEHALF OF
PITKIN COUNTY HUMAN SERVICES
Signature:_________________________
Name:____________________________
Title:_____________________________
Date: _____________________________
Oct-25-2023
Francie Jacober
Pitkin County Commissioner
UPDATED: 09/24/2023
27
ATTACHMENT F: REQUIRED CONTRACT PROVISIONS
1. Remedies: All contracts for more than the simplified acquisition threshold (which is the
inflation adjusted amount determined by the Civilian Agency Acquisition Council and the
Defense Acquisition Regulations Council (Councils) as authorized by 41 U.S.C. 1908),
must address administrative, contractual, or legal remedies in instances where contractors
violate or breach contract terms, and provide for such sanctions and penalties as
appropriate.
2. Termination: All contracts in excess of $10,000 shall contain suitable provisions for
termination, including the manner by which termination shall be effected and the basis for
settlement. In addition, such contracts shall describe the conditions under which the
contract may be terminated for default as well as conditions where the contract may be
terminated due to circumstances beyond the control of the contractor.
3. 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 must 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, 3 CFR Part, 1964-1965 Comp., p. 339), as amended by 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, Department of Labor.”
4. Davis-Bacon Act, as amended (40 U.S.C. 3141-3148): When required by Federal
program legislation, all prime construction contracts in excess of $2,000 awarded by non-
Federal entities must include a provision for compliance with the Davis-Bacon Act (40
U.S.C. 3141-3144, and 3146-3148) as supplemented by Department of Labor regulations
(29 CFR Part 5, “Labor Standards Provisions Applicable to Contracts Covering Federally
Financed and Assisted Construction”). In accordance with the statute, contractors must be
required to pay wages to laborers and mechanics at a rate not less than the prevailing wages
specified in a wage determination made by the Secretary of Labor. In addition, contractors
must be required to pay wages not less than once a week. A copy of the current prevailing
wage determination issued by the Department of Labor must be placed in each solicitation.
The decision to award a contract or subcontract must be conditioned upon the acceptance
of the wage determination. All suspected or reported violations will be reported to the
Federal awarding agency. The contracts must also include a provision for compliance with
the Copeland “Anti-Kickback” Act (40 U.S.C. 3145), as supplemented by Department of
Labor regulations (29 CFR Part 3, “Contractors and Subcontractors on Public Building or
Public Work Financed in Whole or in Part by Loans or Grants from the United States”).
The Act provides that each contractor or subrecipient must be prohibited from inducing,
by any means, any person employed in the construction, completion, or repair of public
work, to give up any part of the compensation to which he or she is otherwise entitled.
5. Contract Work Hours and Safety Standards Act (40 U.S.C. 3701-3708): [Where
applicable] All contracts awarded in excess of $100,000 for contracts that involve the
UPDATED: 09/24/2023
28
employment of mechanics or laborers shall include a provision for compliance with 40
U.S.C. 3702 and 3704, as supplemented by Department of Labor regulations (29 CFR part
5). Under 40 U.S.C. 3702 of the Act, each contractor must be required to compute the
wages of every mechanic and laborer on the basis of a standard work week of 40 hours.
Work in excess of the standard work week is permissible provided that the worker is
compensated at a rate of not less than one and a half times the basic rate of pay for all hours
worked in excess of 40 hours in the work week. The requirements of 40 U.S.C. 3704 are
applicable to construction work and provide that no laborer or mechanic must be required
to work in surroundings or under working conditions which are unsanitary, hazardous, or
dangerous. These requirements do not apply to the purchases of supplies or materials or
articles ordinarily available on the open market, or contracts for transportation or
transmission of intelligence.
6. Rights to Inventions Made Under a Contract or Agreement: Contracts or agreements
for the performance of experimental, developmental, or research work shall provide for the
rights of the Federal Government and HFC in any resulting invention in accordance with
37 CFR part 401, "Rights to Inventions Made by Nonprofit Organizations and Small
Business Agencies Under Government Grants, Contracts and Cooperative Agreements,"
and any implementing regulations issued by the awarding agency.
7. 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 subawards of amounts in excess of
$150,000 shall contain a provision that requires the recipient to agree to comply with all
applicable standards, orders or regulations issued pursuant to the Clean Air Act (42 U.S.C.
7401 et seq.) and the Federal Water Pollution Control Act, as amended (33 U.S.C. 1251 et
seq.). Violations shall be reported to the Federal awarding agency and the Regional Office
of the Environmental Protection Agency (EPA).
8. Debarment and Suspension (E.O.s 12549 and 12689): For all contracts, HFC shall
obtain from the contractor a representation that neither the contractor nor any of its
principal employees are listed on the Excluded Parties List System in SAM.
9. Byrd Anti-Lobbying Amendment (31 U.S.C. 1352): For all contracts or Subawards of
$100,000 or more, HFC shall obtain from the contractor or sub-grantee a certification that
it will not and has not used Federal appropriated funds to pay any person or organization
for influencing or attempting to influence an officer or employee of any agency, a member
of Congress, officer or employee of Congress, or an employee of a member of Congress in
connection with obtaining any Federal contract, grant or any other award covered by 31
U.S.C. 1352. Likewise, since each tier provides such certifications to the tier above it, HFC
shall provide such certifications in all situations in which it acts as a sub-recipient of a sub-
grant of $100,000 or more.
10. Domestic preferences for procurements. As appropriate and to the extent consistent
with law, contractor will, to the greatest extent practicable, 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
UPDATED: 09/24/2023
29
manufactured products).
11. Prohibition on certain telecommunications and video surveillance services or
equipment
HFC and subrecipients are prohibited from entering into a contract (or extend or renew a
contract) to procure or obtain equipment, services, or systems that uses covered
telecommunications equipment or services as a substantial or essential component of any
system, or as critical technology as part of any system. As described in Public Law 115-
232, section 889, covered telecommunications equipment is telecommunications
equipment produced by Huawei Technologies Company or ZTE Corporation (or any
subsidiary or affiliate of such entities).
12. Procurement of recovered materials
A non-Federal entity that is a state agency or agency of a political subdivision of a state
and its contractors must comply with section 6002 of 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 of the item exceeds $10,000 or the value of the
quantity acquired during the preceding fiscal year exceeded $10,000; procuring solid
waste management services in a manner that maximizes energy and resource recovery;
and establishing an affirmative procurement program for procurement of recovered
materials identified in the EPA guidelines.