HomeMy WebLinkAboutbocc.con.096.1999• CONTRACT #_
STATE OF COLORADO
Bill Owens, Governor
Jane E. Norton, Executive Director
Dedicated to protecting and improving the health and environment of the people of Colorado
4300 Cherry Creek Dr. S. Laboratory and Radiation Services Division
Denver, Colorado 80246-1530 8100 Lowry Blvd.
Phone (303) 692-2000 Denver CO 80220-6928
Located in Glendale, Colorado (303) 692-3090
http://www.cdphe.stace.co.us
September 15, 1999
State Fiscal Year 1999-2000 Contracting Routing Number
FLA 0000183
Contract Renewal Letter No. 2
Colorado Department
of Public Health
and Environment
In accordance with Paragraph 10 of the contract with routing number 9807588 and contract number FAA, EMS 9807588 ,
hereinafter referred to as the Original Contract (copy attached and by this reference made a part hereof) between the State of
Colorado, Department of Public Health and Environment EMSP Division and Pitkin County, the parties hereby agree the Original
Contract is hereby renewed for the period of January 1, 2000 through December 31, 2000. The parties agree that the maximum
amount payable by the State for the eligible services during this renewal period is FIFTEEN THOUSAND NINETY TWO
DOLLARS AND THIRTY THREE CENTS ($15,092.33)
ifedget..aft.ftehed-hereffres-A-ttaeliffient437-15eth--ipeeeperateel-liereift. The terms of conditions of the Original Contract are hereby
reaffirmed and shall continue in full force and effect throughout this renewal period unless otherwise stated.
This amendment to the Original Contract is intended to be effective as of January 1, 2000 but in no event shall it be deemed valid
until it shall have been approved by the State Controller or such assistant as he may designate.
Please sign, date and return all three originals of this letter as soon as possible to:
Arleen Way, Grants Manager
Colorado Department of Public Health and Environment
EMSP Division
Mail Code: EMSPD-PCP-A5
4300 Cherry Creek Drive South
Denver, Colorado 80246-1530
One original of this letter will be returned to you when fully approved.
Contractor: Pitkin County
Signatur
Print Name: Q €
Title: Chairperson- Board of County Commissioners
APPROVALS:
PROG
By:
State of Colorado:
Bill Owens, Govemor
By:
For the Executiveil5irector
Colorado Depar
And Environme
APPROVALS:
CONTROLLER
By:
nt of Public Health
COUNTY SUBSIDY PAYMENT DISTRIBUTION FORM
COLORADO EMERGENCY MEDICAL SERVICES SUBSIDY PROGRAM FOR
COUNTIES
In accordance with the provision of CRS 25-3.5-605, the undersigned hereby requests an EMS
county subsidy distribution payment for the improvement and expansion of prehospital EMS. It
is understood that payment is contingent upon approval of the statutatory reporting requirements
by the State Advisory Council on EMS.
Payment To: Board of County Commissioners. Pitkin County
Name of Board of County Commissioners (payee)
506 E. Main Street
Address
Aspen. CO 81611
(City)
Chairperson Board of Saounty CommissioneiX
SIGNATU
Printed Name: ' Iry l _
(State) (Zip)
DATE% /9(7'
SIGN AND RETURN THIS FORM ALONG WITH ALL REPORTING DOCUMENTATION
For use only by Department of Public Health and Environment
Amount: $ 15.092.33
Approved By: Date:
Grants Manager
Fiscal Officer
Date:
Fund Agency Lim Appr Code Fune Obi GBL
409 FLA 8300 839 FLWT 5120 000S
Original Contract Number:9807588
Renewal Routing#: 0000183
Vendor #:846000794 F