Loading...
HomeMy WebLinkAboutbocc.con.024.268/30/2021 CDD Contract Information Contract Number Project Name Contractor Budget Line Item 11437373.531000.10073 Procurement Method: Type: Contract Start Date Contract End Date Contract Type Retainage If this is a new contractor, please enter the New Vendor information into Munis for workflow approval. Contact Information: Department County Representative Jordana Sabella County Representative Phone (970) 920-5062 Provide a brief description of the Contract or Change Order: Contract Value Summary: $ 60,564.00 $ 60,564.00 024.26 Pitkin County Procurement Cover Sheet Please complete the Contract Cover Sheet when the contract/task order is complete and fully executed. Return all Contract Cover Sheets and Contracts/Change Orders/Amendments/Task Orders to Procurement No Family Planning Services Community Health Services $ 60,564.00 Additional Budget Line Item(s) (Please fully allocate New Contract Total) $ - $ - $ - $ 60,564.00 Sole Source Services/Maintenance 1/1/2026 12/31/2026 New Contract Public Health Contract to provide Family Planning Services for Pitkin County residents. Original Contract Amount Previous Change Order/Amendment Amount This Change order/Amendment amount Contract Total Rev 2023.12.15 CDD 1 PITKIN COUNTY SOLE SOURCE PROCUREMENT JUSTIFICATION REQUEST TO: County Manager DATE: December 10, 2025 FROM: Kurt Dahl, Environmental Health Manager Proposed Contractor: Community Health Services (CHS) Product/Service: Family Planning Services Estimated expenditure for the above Product/Service: $ 60,564 This form is required in documenting a Sole Source exception from an otherwise competitive bidding process when sufficient competition does not exist, a single vendor represents a clear and best value to Pitkin County, or other factors are present that preclude other vendors from being able to provide the product(s), service(s), and/or construction. This purchase is clearly and legitimately limited to a Single or Sole Source. (Examples: original manufacturer, no regional distributor, standardization etc): Explain: Pitkin County Public Health (PCPH) is a local public health agency that provides public and environmental health services to residents and visitors of Pitkin County, all municipalities within Pitkin County, and to the regional commuting workforce. Colorado Revised Statutes, CRS, 25-1-506(3)(b)(III) requires all Local Public Health Agencies (PCPH) to provide or arrange for the provision of quality public health services deemed essential by the State Board of Health. Family planning services are included as an essential service of a local public health agency. Prior to the formation of PCPH, Community Health Services (CHS) functioned as the public health agency for Pitkin County for over 40 years and provided public health services to the community, including family planning services. When PCPH was formed in 2017, it was decided that CHS would act as the clinical arm of PCPH, which includes family planning services. This relationship has continued since that time, and PCPH wishes to renew our contracts with CHS, including the Family Planning Contract. There are no competitors due to their upvalley location with the ability to bill Medicare and Medicaid, and the fact that CHS currently has a contract with the Colorado Department of Public Health and Environment (CDPHE) to deliver family planning services. These factors, along with the long history of delivering public health services to the community, make for a strong argument to utilize them as a provider. Funding for this contract will come from the PCPH Public Health Fund which, in part, receives monies from the Pitkin County Healthy Community Fund to support family planning services. CHS also has a contract with Rev 2023.12.15 CDD 2 The undersigned requests that Pitkin County waive other procurement requirements and recognize this transaction as a sole source exception to the Pitkin County Procurement Code. Department Representative Department Director !#COUNTY REPRESENTATIVE#! Date !#SECTION LEADER#! Date County Manager Reason for Denial: ________________________________________ !#COUNTY MANAGER SOLE#! Date Dec-19-2025 Public Health Director Jordana Sabella Kara Silbernagel Jan-13-2026 Interim County Manager Contract # 024.26 Revision: 2024.10.08 iso8601 CDD iso 8601 1 PITKIN COUNTY CONTRACT FOR PROVISION OF SERVICES THIS CONTRACT, made December 18, 2025 by and between the Board of County Commissioners of Pitkin County, Colorado, 530 E. Main St., Suite #302, Aspen, CO 81611, (hereinafter called the “County”) and Community Health Services, 0405 Castle Creek Road, Suite 201, Aspen, CO 81611 (hereinafter called the “Contractor”) to perform the following work: Family Planning Services (“Project”). I. Term of Contract: The term of this Contract is from January 1, 2026 to December 31, 2026. At the expiration of the initial term, the contract may be extended for five (5) additional terms of one (1) year by the express written consent of both parties. II. Contractor’s Obligations. Contractor shall provide Family Planning Services to the residents of Pitkin County in accordance with the Contractor Scope of Work attached hereto and incorporated by reference as (“Attachment A”), including all duties, timelines, reporting requirements, and deliverables set forth therein. III. Compensation and Expenses, Invoicing, Payment and Offset. The County shall compensate Contractor for its services in accordance with the Project Budget and Schedule set out in Paragraph II. It is expressly understood and agreed that in no event will the total compensation and reimbursement to be paid hereunder exceed the sum of Sixty Thousand Five Hundred Sixty-Four dollars and Zero cents ($60,564.00) for all services rendered. By contract or amendment, the County and Contractor may reallocate the budget among project tasks if the total budget amount remains unchanged. Contractor shall invoice Quarterly, with invoice(s) emailed to Pitkin County Public Health no later than the 15th of April, July, October, and January 2027 and shall include, at minimum, an outline of direct costs for quarterly services. The indirect rate for this contract is 10%. Payment should be expected within thirty (30) days of invoice. Any payment by the County may be offset by any amount the Contractor owes the County for any reason. Pitkin County will not release any payment to Contractor prior to receipt of a complete and valid W9. Contractor’s address and the as-filed, legal entity name provided within this Contract must match the information provided with the submitted W9. Doing Business As (“DBA”) entity titles, as applicable, must be preceded by Contractors Contract # 024.26 Revision: 2024.10.08 iso8601 CDD iso 8601 2 legally filed business name. Failure to provide a complete and valid W9 may result in delayed and/or past due payment from the County to Contractor and will in no event obligate the County to recognize or pay penalties for any past due balances withheld as a result of such. Contractor may submit completed W9 forms electronically by emailing pdf copies to AP@PitkinCounty.com with the County Project Contact listed within this Contract in copy. IV. County’s Exclusive Ownership of Work Product. Drawings, specifications, guidelines and other documents prepared by Contractor in connection with this Contract shall be the property of the County. However, Contractor shall have the right to utilize such documents in the course of its marketing, professional presentations, and for other business purposes. Contractor assigns to County the copyrights to all work prepared, developed, or created pursuant to this Contract, including the right to: 1) reproduce the work; 2) prepare derivative works; 3) distribute copies to the public; 4) perform the works publicly; and 5) to display the work publicly. Contractor shall have right to use materials produced in the course of this Contract for marketing purposes and professional presentations, articles, speeches and other business purposes. V. Pitkin County’s Obligations. Pitkin County shall administer this Contract through a County Representative. Jordana Sabella, Public Health Director will manage the project as the County’s Representative. In the event that Jordana Sabella is not available, an alternate County representative will be appointed who shall assume the County Representative’s duties. The services provided and products delivered by the Contractor under this Contract will be subject to review by the County’s Representatives, or a designee, for compliance with Contractor’s obligations prior to final payment. VI. Termination Prior to Expiration of Contract Term. The County has the right to terminate this Contract, with or without cause, by giving written notice to the Contractor of such termination and specifying the effective date thereof. Such notice shall be given at least ten (10) days before the effective date of such termination. In such event all finished or unfinished documents, data, studies and reports prepared by the Contractor pursuant to this Contract shall become the County’s property. Contractor shall be entitled to receive compensation in accordance with the Contract for any satisfactory work completed pursuant to the terms of this Contract prior to the date of termination. Notwithstanding the above, Contractor shall not be relieved of liability to the County for damages sustained by the County by virtue of any breach of the Contract by the Contractor. VII. Independent Contractor Status. A. The parties to this Contract intend that the relationship between them contemplated by the Contract is that of independent contractor. Contractor, and any agent, Contract # 024.26 Revision: 2024.10.08 iso8601 CDD iso 8601 3 employee, or servant of Contractor shall not be deemed to be an employee, agent, or servant of Pitkin County. B. Contractor is not required to offer his services exclusively to Pitkin County under this Contract. Contractor may choose to work for other individuals or entities during the term of this Contract, provided that the basic services and deliverable products required under this Contract are submitted in the manner and on the schedule defined under this Contract. C. Contractor warrants that all work produced will conform to all applicable industry standard of care, skill and diligence in the performance of Contractor’s obligations under this Contract. D. Contractor shall not attempt to oversee or supervise the work or actions of any Pitkin County employee, servant or agent in the course of completing work under this Contract. E. Contractor is not entitled to any Workers’ Compensation benefits through Pitkin County and is responsible for payment of any federal, state, FICA and other income taxes. VIII. Assignability. This Contract is not assignable by either party. Any use of subcontractors by the Contractor for performance of this Contract must be accepted in writing by the County. IX. Severability. In the event that any provision of this Contract shall be held to be invalid or unenforceable, the remaining provisions of this Contract shall remain valid and binding upon the parties hereto. X. Integration and Modification. A. This Contract represents the entire and integrated Contract between the County and the Contractor and supersedes all prior negotiations, representations, or contract, either written or oral. This Contract may be amended only by written contract signed by both the County and the Contractor. B. The County may, from time to time, request changes in the scope of services of the Contractor to be performed hereunder. Such changes, including the increase or decrease in the amount of the Contractor’s compensation, which are mutually agreed upon between the County and the Contractor, shall be in writing and upon execution shall become part of this Contract. XI. Indemnity. A. The Contractor agrees to indemnify, hold harmless and, not excluding the County's right to participate, defend the County, its subsidiary, parent, associated and/or affiliated entities, successors, or assigns, its elected officials, trustees, employees, agents, volunteers, and any jurisdiction or agency issuing permits for any work included in the project, hereinafter referred to as indemnitee, from all suits and claims, including attorney's fees and cost of litigation, actions, loss, damage, Contract # 024.26 Revision: 2024.10.08 iso8601 CDD iso 8601 4 expense, cost or claims of any character or any nature arising out of the work done in fulfillment of the terms of this Contract or on account of any act, claim or amount arising or recovered under workers' compensation law or arising out of the failure of the Contractor to conform to any statutes, ordinances, regulation, law or court decree. It is agreed that the Contractor will be responsible for primary loss investigation, defense and judgment costs where this Contract of indemnity applies. In consideration of the award of this Contract, the Contractor agrees to waive all rights of subrogation against the County its subsidiary, parent, associated and/or affiliated entities, successors, or assigns, its elected officials, trustees, employees, agents, and volunteers for losses arising from the work performed by the Contractor for the County. B. The Contractor further shall investigate, process, respond to, adjust, provide defense for and defend, pay or settle all claims, demands, or lawsuits related hereto at its sole expense and shall bear all other costs and expenses related thereto, even if the claim, demand or lawsuit is groundless, false or fraudulent. C. Accessibility Indemnification Contractor shall indemnify, save, and hold harmless the Indemnified Parties, against any and all costs, expenses, claims, damages, liabilities, court awards and other amounts (including attorneys’ fees and related costs) incurred by any of the Indemnified Parties in relation to Contractor’s failure to comply with §§24-85- 101, et seq., C.R.S., or the Accessibility Standards for Individuals with a Disability as established by OIT pursuant to Section §24-85-103 (2.5), C.R.S. XII. Accessibility. i. Contractor shall comply with and the Work Product provided under this Contract shall be in compliance with all applicable provisions of §§24-85-101, et seq., C.R.S., and the Accessibility Standards for Individuals with a Disability, as established by OIT pursuant to Section §24-85-103 (2.5), C.R.S. Contractor shall also comply with all State of Colorado technology standards related to technology accessibility and with Level AA of the most current version of the Web Content Accessibility Guidelines (WCAG), incorporated in the State of Colorado technology standards. The State may require Contractor’s compliance to the State’s Accessibility Standards to be determined by a third party selected by the State to attest to Contractor’s Work Product and software is in compliance with §§24-85-101, et seq., C.R.S., and the Accessibility Standards for Individuals with a Disability as established by OIT pursuant to Section §24-85-103 (2.5), C.R.S. XIII. Insurance. Contractor and subcontractors shall procure and maintain until all of their obligations have been discharged, including any warranty periods under this Contract are satisfied, insurance against claims for injury to persons or damage to property which may arise from or in connection with the performance of the work hereunder by the Contract # 024.26 Revision: 2024.10.08 iso8601 CDD iso 8601 5 Contractor, its agents, representatives, employees or subcontractors. The insurance requirements herein are minimum requirements for this Contract and in no way limit the indemnity covenants contained in this Contract. The policies shall include, or be endorsed to include, the following provision: On insurance policies where the County is named as an additional insured, the County shall be an additional insured to the full limits of liability purchased by the Contractor even if those limits of liability are in excess of those required by this Contract. The County in no way warrants that the minimum limits contained herein are sufficient to protect the Contractor from liabilities that might arise out of the performance of the work under this Contract by the Contractor, its agents, representatives, employees, or subcontractors. The Contractor shall assess its own risks and if it deems appropriate and/or prudent, maintain higher limits and/or broader coverages. The Contractor is not relieved of any liability or other obligations assumed or pursuant to the Contract by reason of its failure to obtain or maintain insurance in sufficient amounts, duration, or types. Commercial General Liability Completed Operations coverage must be kept in effect for up to three (3) years after completion of the project. A. Coverage and Limits of Insurance. Contractor shall provide coverage with limits of liability requirements provided that the coverage is written on a “following form” basis. 1) Statutory Workers’ Compensation: Colorado statutory minimums a. Policy shall contain a waiver of subrogation against the County. b. This requirement shall not apply when a contractor or subcontractor is exempt under Colorado Workers’ Compensation Act AND when such contractor or subcontractor executes the appropriate sole proprietor waiver form. Minimum Limits: Coverage A (Workers’ Compensation) Statutory Coverage B (Employers Liability) $ 500,000 $ 500,000 $ 500,000 2) Commercial General Liability – ISO 1CG 0001 form or equivalent. (With County named as an additional insured) Minimum Limits: General Aggregate $ 2,000,000 Products/Completed Operations Aggregate $ 2,000,000 Each Occurrence Limit $ 1,000,000 Personal/Advertising Injury $ 1,000,000 Contract # 024.26 Revision: 2024.10.08 iso8601 CDD iso 8601 6 Fire Damage (Any One Fire) $ 50,000 Medical Payments (Any One Person) $ 5,000 Coverage to include: • Premises and Operations • Explosions, Collapse and Underground Hazards • Personal / Advertising Injury • Products / Completed Operations • Liability assumed under an Insured Contract (including defense costs assumed under contract) • Independent Contractors • Designated Construction Project(s) General Aggregate Limit, ISO CG 2503 (1997 Edition or equivalent) • Additional Insured—Owners, Lessees or Contractors Endorsement, ISO Form 2010 (2004 Edition or equivalent) • Additional Insured—Owners, Lessees or Contractors Endorsement, ISO CG 2037 (2004 Edition or equivalent) • The policy shall be endorsed to include the following additional insured language on the Additional Insured Endorsements specified above: “County, its subsidiary, parent, associated and/or affiliated entities, successors, or assigns, its elected officials, trustees, employees, agents, and volunteers named as an additional insured with respect to liability and defense of suits arising out of the activities performed by, or on behalf of the Contractor, including completed operations”. 3) Auto Liability: Bodily injury and property damage for any owned, hired and non-owned vehicles used in the performance of this Contract. Minimum Limits: Statutory Coverage Bodily/Property Damage (Each Accident) $ 1,000,000 4) Special Coverages (check as appropriate and insert amount): a. ☐ Performance Bond $ b. ☐ Professional Errors and Omissions c. ☐ Aircraft Liability d. ☐ Owner’s Protective e. ☐ Builder’s Risk f. ☐ Boiler and Machinery g. ☐ Loss of Use Insurance h. ☐ Pollution Liability i. ☐ Crime, including Employee Dishonesty Coverage, or Fidelity Bond B. Proof of Insurance: Contract # 024.26 Revision: 2024.10.08 iso8601 CDD iso 8601 7 1) Each insurance policy required by the insurance provisions of this Contract shall provide the required coverage and shall not be suspended, voided or canceled except after thirty (30) days prior written notice has been given to the County, except when cancellation is for non-payment of premium, then ten (10) days prior notice may be given. Such notice shall be emailed directly to Procurement@pitkincounty.com. If the insurance carrier will not provide the required notice, the Consultant/Contractor and or its insurance broker shall notify the County of any cancellation, or reduction in coverage or limits of any insurance within seven (7) days of receipt of insurers’ notification to that effect. Simultaneously with the Certificates of Insurance, the Contractor shall file with the Project Lead a certified statement as to claims pending against the required coverages, reserves established on account of such claims, defense costs expended and amounts remaining on policy limits. 2) In addition, these Certificates of Insurance shall contain the following clauses: a. The contractor’s insurance shall be primary and non-contributory with any insurance or self-insurance purchased by the County. b. The insurance companies issuing the policy or policies hereunder shall have no recourse against the County of Pitkin for payment of any premiums or for assessments under any form of policy. c. Any and all deductibles or self-insured retentions in the above- described insurance policies shall be assumed by and be for the amount of, and at the sole expense of the Contractor. d. Location of operations shall be: “all operations and locations at which work for the referenced Project is being done.” 3) Certificates of Insurance for all renewal policies shall be delivered to the County’s Representative at least fifteen (15) days prior to a policy’s expiration date except for any policy expiring on the expiration date of this Contract or thereafter. 4) The County reserves the right to request and receive a copy of any policy and any policy endorsement at any time during the term of this Contract. XIV. Exemptions and Preferences. All purchases of construction or building or any other materials for this Contract shall not include Federal Excise Taxes or Colorado State or local sales or use taxes. Pitkin County is exempt from such taxes under registration numbers 98-02624 and 84-78000-5k. XV. Records. The Contractor shall maintain comprehensive, complete and accurate books, records, and documents concerning its performance relating to this Contract for a period of three (3) years after final payment under the Contract and the County shall have the right within the three (3) year period to inspect and audit these books, records Contract # 024.26 Revision: 2024.10.08 iso8601 CDD iso 8601 8 and documents, upon demand, in a reasonable manner and at reasonable times, for the purpose of determining, by accepted accounting and auditing standards, compliance with all provisions of the Contract and applicable law. XVI. Contract Made in Colorado. The parties agree that this Contract was made in accordance with the laws of the State of Colorado and shall be so construed. Venue is agreed to be exclusively in the courts of Pitkin County, Colorado. XVII. Attorney’s Fees. In the event that legal action is necessary to enforce any of the provisions of this Contract, the substantially prevailing party shall be entitled to its costs and reasonable attorney’s fees. XVIII. Governmental Immunity. Contractor agrees and understands that Pitkin County is relying on and does not waive, by any provision of this Contract, the monetary limitations or terms (presently $150,000 per person and $600,000 per occurrence) or any other rights, immunities, and protections provided by the Colorado Governmental Immunity Act, 24-10-101, et seq., C.R.S., as from time to time amended, or otherwise available to Pitkin County or any of its officers, agents or employees. Further, nothing in this Contract shall be construed or interpreted to require or provide for indemnification of the Contractor by the County for any injury to any person or any property damage whatsoever which is caused by the negligence or other misconduct of the County or its agent or employees. XIX. Current Year Obligations. The parties acknowledge and agree that any payments provided for hereunder or requirements for future appropriations shall constitute only currently budgeted expenditures of Pitkin County. Pitkin County’s obligations under this Contract are subject to Pitkin County’s annual right to budget and appropriate the sums necessary to provide the services set forth herein. No provisions of the Contract shall constitute a mandatory charge or requirement in any ensuing fiscal year beyond the then current fiscal year of Pitkin County. No provision of the Contract shall be construed or interpreted as creating a multiple-fiscal year direct or indirect debt or other financial obligation of Pitkin County within the meaning of any constitutional or statutory debt limitation. This Contract shall not directly or indirectly obligate Pitkin County to make any payments beyond those appropriated for Pitkin County’s then current fiscal year. No provisions of this Contract shall be construed to pledge or create a lien on any class or source of Pitkin County’s moneys, nor shall any provision of this Contract restrict the future issuance of Pitkin County’s bonds or any obligations payable from any class or source of Pitkin County’s money. XX. Notice. Any notice required or permitted under this Agreement shall be in writing and shall be provided by electronic delivery to the e-mail addresses set forth below and by one of the following methods 1) hand-delivery or 2) registered or certified mail, postage pre-paid to the mailing addresses set forth below. Each party by notice sent Contract # 024.26 Revision: 2024.10.08 iso8601 CDD iso 8601 9 under this paragraph may change the address to which future notices should be sent. Electronic delivery of notices shall be considered delivered upon receipt of confirmation of delivery on the part of the sender. Nothing contained herein shall be construed to preclude personal service of any notice in the manner prescribed for personal service of a summons or other legal process. To Pitkin County: Jordana Sabella Street Address City, ST ZIP Email: Jordana.Sabella@pitkincounty.com with copies to: Pitkin County Attorney’s Office 530 E. Main St., Suite #301 Aspen, Colorado 81611 Email: Attorney@pitkincounty.com To Contractor: Community Health Services 0405 Castle Creek Road, Suite 201 Aspen, CO 81611 Phone: ( ) - Email: logan.hood@aspencommunityhealth.org Contract # 024.26 Revision: 2024.10.08 iso8601 CDD iso 8601 10 IN WITNESS WHEREOF, the parties have executed this Contract as of the date first set out herein above. COMMUNITY HEALTH SERVICES ________________________________________________ !#VENDOR SIGNATURE#! Date PITKIN COUNTY, COLORADO RECOMMENDED FOR APPROVAL: _________________________________________________ !#DEPARTMENT REPRESENTATIVE#! Date COUNTY MANAGER APPROVAL: ________________________________________________ !#COUNTY MANAGER#! Date Jordana Sabella Public Health Director Dec-19-2025 Executive Director Dec-28-2025 Logan Hood Jan-13-2026 Kara Silbernagel Interim County Manager 2026 Family Planning Services Scope of Work Duties and Responsibilities: Community Health Services (CHS) shall provide the following services to Pitkin County Public Health (PCPH): 1. CHS shall perform all activities in the period required in the attached Statement of Work from the Colorado Department of Public Health and Environment (CDPHE). a. Attachment A: CDPHE Family Planning SOW 2026*292 b. Attachment B: Budget 2. Data a. CHS shall collect data related to its Family Planning work as outlined in Attachment C. b. CHS shall do an annual presentation by March 31st each year for the previous year’s data. The presentation will be to the PCPH staff, the Board of Health, or other entities and will be based on the data collected. The purpose of the presentation is for PCPH staff to understand the work CHS does each year on Family Planning services. 3. CHS shall complete the quarterly invoice template provided by PCPH, which outlines the direct cost for quarterly services. Any questions regarding the template should be directed to the PCPH Accounting Analyst. Accountability: A designated representative from CHS will participate in quarterly meetings, or more frequently as reasonably needed or requested, with Pitkin County Public Health’s CHS Contract Manager, or designee. The meetings will be a forum to provide updates and discuss accomplishments, challenges, and barriers. Compensation: The indirect rate for this contract is 10%. The total compensation under this Agreement shall not exceed $60,564 for the term ending December 31, 2026. Quarterly Invoices are to be emailed to PCPHno later than the 15th of April, July, October 2026, and January 2027. Additional funding for family planning services from Eagle and Garfield Counties is pending. Please notify PCPH of any additional grant awards or changes to services required by Colorado or the Federal Government for the 2026 budget year within 30 days of acknowledgment of the award. Attachment A Attachment A STATEMENT OF WORK To Original Contract Number: 2026*0292 These provisions are to be read and interpreted in conjunction with the provisions of the contract specified above. I. Entity Name: Community Health Services, Inc. II. Project Description: his health project serves to provide access to sexual and reproductive health (SRH) services to l Coloradans. The Colorado Department of Public Health and Environment (CDPHE) Family lanning Program (FPP) receives Federal Title X grant funding as well as State funding to mprove equitable access to SRH care by contracting with a network of health care providers round the state, such as the Contractor. All subrecipients of CDPHE FPP’s Title X funding must omply with the associated federal regulations as well as requirements. Priority is given to atients with incomes that are at or below 250% of the Federal Poverty Level (FPL). During the roject term, the Contractor will provide high-quality, confidential, patient-centered SRH services sing a sliding fee sca le for self-pay patients. SRH services include, but not limited to ontraceptive services, preventative health counseling and education services, reproductive ealth related testing, and screening and referrals. he direct beneficiary of the project will be Coloradans in need of affordable SRH services, such s those provided by the Contractor. To achieve the goals of this project, the Contractor will articipate in training, technical assistance, data reporting, quality assurance and quality mprovement activities, and community engagement and outreach. The project will be ongoing ntil the end of this contract’s term. Attachment A III. Definitions: 1. CDPHE – Colorado Department of Public Health and Environment 2. FPL – Federal Poverty Level 3. FPP – CDPHE’s Family Planning Program 4. HIPAA – Health Insurance Portability and Accountability Act 5. iCare – FPP data system used to collect encounter-level data 6. I&E – Information and Education committee that reviews and approves print and electronic informational and educational materials developed or made available under the project 7. IUD – intrauterine device 8. LEP – Limited English Proficiency 9. QFP – Quality Family Planning Recommendations 10. SRH – Sexual and Reproductive Health 11. Title X – refers to the federal Title X Family Planning Services Grant funding and requirements IV. Work Plan Goal #1: Improve the health, well-being and equity of all people in Coloradans through health promotion, prevention and access to healthcare. Objective #1: No later than the expiration date of this contact, improve access to affordable, high-quality, patient-centered sexual and reproductive health (SRH) services with priority for patients experiencing greater barriers to accessing care. Primary Activity #1: The Contractor shall provide ongoing clinical SRH services to patients. Attachment A Sub-Activity #1: 1. The Contractor shall provide clinical SRH services in accordance with the most recent CDPHE FPP Clinical Manual, the Quality Family Planning Recommendations (QFP) and recognized national standards of care including: a. Contraceptive counseling, education, supplies, and services b. Pregnancy testing and nondirective options counseling with patient-led referral c. Services related to achieving pregnancy d. Basic infertility services e. Preconception health services f. Sexually transmitted infection screening, testing, treatment, referral, and education and counseling g. Related preventative reproductive health services and referrals, including cervical cancer screening and referral to mammography 2. The Contractor shall provide clinical follow-up and referrals, as appropriate 3. The Contractor shall use a qualified laboratory to provide the services outlined in the CDPHE FPP Clinical Manual, which cannot be performed by the Contractor. 4. The Contractor shall provide a broad range of acceptable and effective contraceptive methods and services, including the full range of FDA-approved contraceptive products and fertility awareness-based methods, on-site (or by prescription if the patient prefers). This range shall include, at a minimum, the following options: a. One (1) hormonal intrauterine device (IUD) b. One (1) non-hormonal IUD c. One (1) contraceptive implant d. Three (3) types of combined oral contraceptive pills e. One (1) progestin only contraceptive pill f. One (1) contraceptive injection Attachment A g. One (1) hormonal non-pill method such as the contraceptive patch or vaginal ring h. Condoms i. Fertility-awareness based method education provided by staff specifically trained in providing this education 5. The Contractor shall provide referrals to SRH patients to other social and medical services, as needed, including: a. Primary care providers b. Mental health providers c. Medicaid enrollment assistance d. Social and financial support programs such as Women’s Infants and Children (WIC), Temporary Assistance for Needy Families (TANF), Supplemental Nutrition Assistance Program (SNAP), etc. e. Local agencies offering services related to intimate partner violence, housing, employment, or other patient needs. 6. The Contractor shall develop steps to ensure access for priority populations experiencing greater barriers to accessing care including patients who are adolescents, low-income, uninsured, underinsured, LEP, and/or in need of confidential services, such as: a. Providing adolescent-friendly services to young people, which are accessible, acceptable, equitable, appropriate, and effective. b. Never requiring the consent or notification of parents or guardians for minors who wish to seek services independently. Family participation must be encouraged but never required. c. Counseling adolescents clients to resist sexual coercion, and documenting this counseling. d. Providing meaningful access to patients with LEP by offering printed materials in multiple languages and engaging qualified services (through a language line service or bilingual staff) for medical interpretation, and supporting this work through specific written policies. Attachment A e. Identifying patients with confidentiality concerns related to communications or billing and taking steps to protect patient confidentiality, as described in the CDPHE FPP Administrative Manual. 7. The Contractor shall develop documented clinical policies, procedures and protocols in accordance with the FPP Clinical Manual, the QFP and nationally recognized standards of care, including contraceptive method specific protocols, an adolescent care policy, and policies regarding pregnancy testing, nondirective options counseling and the prohibition of abortion. Primary Activity #2: The Contractor shall implement fiscal practices that meet Title X requirements for billing and collections. Attachment A Sub-Activity #2: 1. The Contractor shall comply with the requirement to not deny services based on a patient’s inability to pay or create barriers to accessing care through fiscal practices. a. The Contractor shall develop policies and procedures in accordance with the FPP Administrative Manual that address income verification, charges, billing, and collections of patient fees without burdening patients or creating barriers to access, including a process for waiving and/or writing off fees. 2. The Contractor shall use a Sliding Fee Scale to charge patients for SRH services, in accordance with Title X requirements. a. The Contractor shall use a reasonable cost-setting methodology to develop a Fee Schedule for SRH services designed to recover the reasonable cost of providing services. i. CDPHE shall periodically offer technical assistance to support the Contractor in updating their fee schedule. b. The Contractor shall create and update a Schedule of Discounts to be applied to the Fee Schedule using the most recent Federal Poverty Guidelines, such that: i. Patients with incomes at or below 100% FPL, as defined by the Department of Health & Human Services (HHS), shall not be charged for SRH services. ii. Patients with family incomes between 101 to 250% FPL will be charged in accordance with a schedule of discounts based on ability to pay. iii. Patients with family income greater than 250% FPL will be charged the full fee. 3. The Contractor shall conduct reasonable efforts to obtain third-party payment from government or other payers who are authorized or legally obligated to pay for services without jeopardizing patient confidentiality. a. The Contractor shall bill and receive reimbursement from Colorado Medicaid, unless a written waiver of this requirement is received from CDPHE. Attachment A b. The Contractor shall work toward, if not currently, generating income through billing and reimbursement from other third-party payers, such as commercial insurance plans. Primary Activity #3: The Contractor shall hire appropriate, trained personnel to meet the requirements of the CDPHE Family Planning Program (FPP) and this contract. Attachment A Sub-Activity #3: 1. The Contractor shall hire and train adequate staffing to deliver the clinical services outlined in this agreement. All professional health care providers must be in compliance with State and Federal licensing requirements and regulations. 2. The Contractor shall hire and train adequate staffing to meet the personnel requirements specified in the most recent CDPHE FPP Administrative Manual. 3. The Contractor shall comply with the requirement that the staff person(s) responsible for program coordination and fiscal functions to review the CDPHE Post-Award communications within thirty (30) days of the execution of this contract if the Cost-Reimbursement Reimbursement Mechanism is selected. If the Advance Payment Reimbursement Mechanism is selected the review will occur within fourteen (14) days. a. Throughout the remainder of this agreement, any new coordinator or fiscal staff responsible for FPP activities shall be required to participate in a program and fiscal orientation with CDPHE within sixty (60) days of employment. 4. The Contractor shall schedule all new staff working with the Title X program in any capacity to complete Title X orientation within (60) days of hire (or beginning to work on FPP), including clinical, administrative, fiscal, operations, data, or other staff. 5. The Contractor shall document that staff complete the FPP’s Annual Training Plan, as appropriate given role and tenure, in accordance with the requirements of each year’s plan. 6. The Contractor shall require relevant staff to review key Title X requirements (as outlined in the Staff Annual Title X Acknowledgement Form ), the CDPHE Administrative Manual, and the CDPHE Clinical Manual annually. 7. The Contractor shall document records of staff training. 8. The Contractor shall attend three virtual CDPHE FPP meetings to review and discuss issues related to FPP program compliance such as data management, community engagement, policies and procedures, adolescent services, etc. At a minimum, the Contractor will attend 2 of the 3 virtual meetings. 9. The Contractor shall attend Post Award Meeting(s) (to include program and fiscal orientation) as announced and scheduled by CDPHE FPP.". Primary Activity #4: The Contractor shall conduct community engagement and outreach. Attachment A Sub-Activity #4: 1. The Contractor shall conduct at least one (1) outreach activity annually to promote the availability of services. 2. The Contractor shall facilitate community engagement in reviewing and approving informational and educational materials, prior to their distribution, to assure that the materials are suitable for the population or community by hosting an Information & Education (I&E) Committee at least one (1) time per year, in accordance with the guidance provided in the CDPHE FPP Administrative Manual. 3. The Contractor shall use one option for how they will meet this requirement after the Post Awards Meeting (PAM) or Post Awards communication. The contractor shall seek approval in writing from CDPHE to change their I&E Committee selection. a. Maintain an I&E Committee exclusive to their own organization (this provides full autonomy to the Contractor for their own informational and educational materials), or b. Join a regional I&E Committee to jointly review and approve informational and educational materials (Contractors in similar communities to share I&E Committee responsibilities and materials). Primary Activity #5: The Contractor shall perform quality assurance and quality improvement activities. Sub-Activity #5: 1. The Contractor shall conduct at least one (1) patient satisfaction survey of SRH patients annually to inform clinical services and quality improvement projects. 2. The Contractor shall attend one (1) quality assurance activity annually with CDPHE, completing one of the following each year in rotation: a. Administrative & Fiscal Site Visit b. Clinical Site Visit c. Self-Audit of Patient Charts Primary Activity #6: The Contractor shall report appropriate data regarding work performed under this agreement. Attachment A Sub-Activity #6: 1. The Contractor shall complete progress reports to submit by the last business day of July and January. Report due dates will be shared with the Contractor via newsletter and email reminders. 2. The Contractor shall upload encounter-level data on the SRH services provided to iCare on a quarterly basis, or more frequently if requested, in accordance with the reporting guidance provided by CDPHE. a. The Contractor shall request access for iCare users in writing, submitted to cdphe_familyplanning@state.co.us . 3. The Contractor shall provide other necessary data required for federal reporting, collected by CDPHE through a supplementary survey annually. 4. The Contractor shall update the Contractor’s contact information in the Agency Management System (AMS). a. This includes staff identified for roles such Project Coordinator, Fiscal Contact, Signature Authority, etc. 5. The Contractor shall report Expenditure and Revenue data, in accordance with the template and guidance provided by CDPHE, on a monthly basis with its invoice. 6. The Contractor shall comply with other data collection and/or state-level evaluation efforts, as appropriate. Attachment A Standards and Requirements: 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 updates and comply with all updates. 2. The Contractor shall comply with the requirement to not subcontract any of the required services as outlined in the CDPHE FPP Administrative Manual without prior written approval from CDPHE. a. The Contractor shall be responsible for monitoring any subcontracted providers of Title X services for compliance with all State and Federal requirements. 3. The Contractor shall comply with guidelines and requirements described in the CDPHE FPP Administrative Manual and CDPHE FPP Clinical Manual. The services provided by the Contractor to the patients it serves shall be performed pursuant to law and in accordance with prevailing medical standards of care for the same or similar medical, nursing and professional services. The services provided shall also comply with applicable: a. CDPHE FPP Administrative Manual and Clinical Manual at https://cdphe.colorado.gov/fpp/subrecipient-resources/manuals-and-guides b. Any applicable fiscal or administrative policies, laws, and regulations of the State or Federal government, incorporated and made part of this contract by reference, available at https://cdphe.colorado.gov/fpp/subrecipient-resources . 4. The Contractor shall comply with applicable State and Federal laws and regulations related to patient confidentiality in providing SRH services: a. The Contractor shall document compliance with the Health Insurance Portability and Accountability Act (HIPAA) and other relevant state and federal statutes protecting privacy and confidentiality of patient health information and medical records. b. The Contractor shall document that all information as to personal facts and circumstances about patients obtained by the project staff is held confidential and not disclosed without the individual’s documented consent. Contractor shall develop and adhere to appropriate safeguards for confidentiality, including prohibiting providers from releasing a patient’s individual information unless the provider has written authorization for the Attachment A release, the release is necessary to provide services to the patient, or the state or federal law requires the release. 5. The Contractor shall comply with all applicable Colorado State and Federal Title X regulations when using contract funds contained in this Contract to fulfill the Statement of Work. Services provided shall comply with applicable: a. Title X statute, regulations, and legislative mandates incorporated and made part of this contract by reference, available at https://opa.hhs.gov/grant-programs/title-x-service-grants/title-x-statutes-regula tions-and-legislative-mandates . b. The Contractor shall comply with the Colorado State regulation (Colo. Rev. Stat. § 13-22- 105) that all adolescents, regardless of age must be allowed services and may consent for their own visits. Service provision cannot be conditioned on parental consent or notification. c. The Contractor shall comply with the requirement that any subcontractors are fulfilling Title X requirements by embedding the Title X regulations and requirements into the subcontractor Memorandum of Understanding (MOU), contracts, and/or interagency agreements. 6. The Federal and/or State family planning funding provided by CDPHE cannot be the sole funder of the Contractor’s SRH services or program. The Contractor shall show a financial contribution of other funds from local, regional, grant, patient, Medicaid, or other third party revenue sources. 7. The Contractor shall use program income generated by billing and reimbursement for SRH services (patient fees, donations, and third-party billing) for the purposes of supporting the program and further delivery of SRH services. 8. The Contractor shall develop written policies, procedures, and protocols as required by Title X regulations and family planning program guidelines. The Contractor may adapt templates provided by the FPP for this requirement, or use their own policies and procedures. 9. The Contractor shall review , share and act, when appropriate, on the information provided in the FPP’s biweekly newsletter, which is the primary mode of communicating important FPP information and updates, emailed from CDPHE to the contractors. The Contractor shall stay informed of changes in policy, updates to program reporting, and programmatic changes. 10. The Contractor shall provide fiscal oversight and shall be solely responsible for compliance with all provisions and deliverables under this Contract. Attachment A 11. The Contractor shall submit communications to the FPP inbox via email ( cdphe_familyplanning@state.co.us ). 12. The Contractor shall comply with FPP email communications, such as requests for information, data and/or meetings, etc., within five (5) business days. Expected Results of Activity(s): 1. Increased number of people getting their SRH needs met with high-quality clinical services, through increased access and improved equity. Measurement of Expected Results: 1. Qualitative and quantitative data collected from required activities and deliverables compared to historical data. Deliverables: Description Completion Date 1. The Contractor shall submit a record of required staff training completed for: i. New staff orientation ii. Annual Training Plan iii. Staff Acknowledgement of Title X Requirements iv. CDPHE FPP Administrative & Clinical Manuals Review No later than 6/30 annually 2. The Contractor shall submit documentation of the outreach activity conducted. No later than 6/30 annually 3. The Contractor shall submit documentation of the I&E Committee hosted. No later than 6/30 annually 4. The Contractor shall submit documentation of the client satisfaction survey conducted. No later than 6/30 annually 5. The Contractor shall submit documentation as requested for the applicable quality assurance activity (administrative and fiscal site visit, clinical site visit, or chart review). No later than the deadline provided by CDPHE FPP Staff. 6. The Contractor shall submit bi-annual progress reports. No later than 1/31 and 7/15 annually. Attachment A 7. The Contractor shall submit encounter-level data on services provided to all SRH patients through iCare ( https://www.healthinformatics.dphe.state.co.us ), in accordance with the specifications provided by the FPP. No later than the 15th of he month for each quarter October 15, January 15, pril 15, and July 15, or by deadline provided by CDPHE FPP Staff 8. The Contractor shall update organization contact information in the Agency Management System (AMS). No later than 30 days of contact information change 9. The Contractor shall submit Expenditure and Revenue Report data through the monthly invoice process. No later than forty-five 45) days after the last day of each month 10. The Contractor shall submit any subcontract or any memorandum of understanding pertaining to this contract to CDPHE for prior approval. o later than 30 days prior o the intended start date f the subcontract or MOU V. Monitoring CDPHE’s monitoring of this contract for compliance with performance requirements will be conducted throughout the contract period by the CDPHE Family Planning Program Team (i.e. Program Manager, Medical Director, Program Coordinator, and Program Assistant). Methods used will include a review of documentation determined by CDPHE to be reflective of performance to include progress reports and data 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 of the life of the contract. Attachment A VI. Resolution of Non-Compliance The Contractor will be notified in writing within thirty ( 30 ) calendar days of discovery of a compliance issue. Within forty-five ( 45 ) 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. If extenuating circumstances arise that require an extension to the timeline, the Contractor must email a request to the CDPHE Family Planning Program Team (i.e Program Manager, Medical Director, Program Coordinator, and Program Assistant) and receive approval for a new due date. The State will oversee the completion/implementation of the action(s) to ensure timelines 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 provisions of this contract. Attachment A Attachment B Community Health Services 2026 Family Planning Budget Expenses Personnel Salaries $295,000.00 5% increase for FP staff Fringe Benefits $73,000.00 3% Total Personnel $368,000.00 Operating Program Expenses/Supplies $75,000.00 Program Services $10,000.00 Total Operating $85,000.00 Total Expenses $453,000.00 Less Revenues: grants, fees, other income $(290,764.00) Total Expenses over (under) Revenues $162,236.00 Revenues: Pitkin County PH Contract $60,564.00 Program Fees (insurance income) $50,000.00 Other funding/grant support $178,000.00 2026 Less Title X funds 20% Donations $2,200.00 Total $290,764.00 Attachment A Attachment C CHS Family Planning Data Points - Prenatal Care - Ketelcheck Index - Kessner Index - Payment Form - Flat fee - Insured - Emergency Medicaid - Regular Medicaid - Demographic - Gender (Female, Nonbinary, Trans) - Age (DOB) - Race/Ethnicity - County of Residence - Reason for Visit - Family Planning - Prenatal (gonorrhea, chlamydia and genital syphilis) - Birth Control options and education (LARC/IUD, pills, injections - Pregnancy Testing - Pregnancy intention - Birth Spacing counseling - Infertility consultation and referrals - STI Testing/Treatment - STI testing - Rapid HIV/Sysphilis, HIV/AIDS, Herpes, Hep C (new), Gonorrhea, HPV, Chlamydia, Oral HPV (new) - Treatment for STIs (antibiotics) - Diagnostic Care - Pap smears - Breast exams - HPV abnormalities - Referrals for mammography (ages 40-64) Attachment A Certificate Of Completion Envelope Id: 179FEB2E-4514-4366-AA7D-959586D85A63 Status: Completed Subject: Community Health Services | Pitkin County Contract 024.26 for Review & Signature Source Envelope: Document Pages: 31 Signatures: 5 Envelope Originator: Certificate Pages: 5 Initials: 1 Pitkin County Procurement AutoNav: Enabled EnvelopeId Stamping: Disabled Time Zone: (UTC-07:00) Mountain Time (US & Canada) 530 East Main Street Suite 203 Aspen, CO 81611 Procurement@PitkinCounty.com IP Address: 2605:59ca:229c: Record Tracking Status: Original 12/19/2025 11:23:26 AM Holder: Pitkin County Procurement Procurement@PitkinCounty.com Location: DocuSign Signer Events Signature Timestamp Connie Baker connie.baker@pitkincounty.com Budget Director Pitkin County Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 74.244.9.71 Sent: 12/19/2025 11:25:35 AM Viewed: 12/19/2025 11:29:31 AM Signed: 12/19/2025 11:29:39 AM Electronic Record and Signature Disclosure: Not Offered via Docusign Jordana Sabella Jordana.Sabella@PitkinCounty.com Public Health Director Pitkin County Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 2601:281:17e:1480:d03e:fa53:94e5:69 Sent: 12/19/2025 11:29:42 AM Viewed: 12/19/2025 1:47:08 PM Signed: 12/19/2025 1:47:50 PM Electronic Record and Signature Disclosure: Not Offered via Docusign Logan Hood logan.hood@aspencommunityhealth.org Executive Director Security Level: Email, Account Authentication (None)Signature Adoption: Pre-selected Style Using IP Address: 2600:100e:b03e:bd99:aca1:cd7a:fafe:e4dc Signed using mobile Sent: 12/19/2025 1:47:53 PM Viewed: 12/19/2025 1:48:18 PM Signed: 12/28/2025 1:12:09 PM Electronic Record and Signature Disclosure: Accepted: 1/12/2026 10:15:52 AM ID: 1c00cdf9-cffd-4b74-87f2-9f40f0149894 Company Name: Pitkin County, Colorado Kara Silbernagel kara.silbernagel@pitkincounty.com Interim County Manager Pitkin County Colorado Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address: 65.38.144.66 Sent: 12/28/2025 1:12:11 PM Resent: 1/5/2026 10:34:39 AM Resent: 1/12/2026 9:27:02 AM Viewed: 1/13/2026 1:25:18 PM Signed: 1/13/2026 1:26:31 PM Electronic Record and Signature Disclosure: Signer Events Signature Timestamp Accepted: 6/26/2025 10:29:11 AM ID: 13c88870-faf6-4375-8fed-1bd1d274f164 Company Name: Pitkin County, Colorado In Person Signer Events Signature Timestamp Editor Delivery Events Status Timestamp Agent Delivery Events Status Timestamp Intermediary Delivery Events Status Timestamp Certified Delivery Events Status Timestamp Carbon Copy Events Status Timestamp Pitkin County Procurement procurement@pitkincounty.com Ruslana Ivanova, Procurement Specialist Pitkin County Security Level: Email, Account Authentication (None) Sent: 1/13/2026 1:26:33 PM Electronic Record and Signature Disclosure: Not Offered via Docusign Accounts Payable AP@pitkincounty.com Accounts Payable Pitkin County Security Level: Email, Account Authentication (None) Sent: 1/13/2026 1:26:34 PM Electronic Record and Signature Disclosure: Not Offered via Docusign Witness Events Signature Timestamp Notary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 12/19/2025 11:25:35 AM Certified Delivered Security Checked 1/13/2026 1:25:18 PM Signing Complete Security Checked 1/13/2026 1:26:31 PM Completed Security Checked 1/13/2026 1:26:34 PM Payment Events Status Timestamps Electronic Record and Signature Disclosure ELECTRONIC RECORD AND SIGNATURE DISCLOSURE From time to time, Pitkin County (we, us or Pitkin County) may be required by law to provide you with certain written notices or disclosures. Described below are the terms and conditions for providing to you such notices and disclosures electronically when we send you documents for electronic signature. Acknowledging your Access, Intent, and Consent to Receive and Sign Materials Electronically To confirm that you can access this information electronically, which will be similar to other electronic notices and disclosures that we will provide to you, please verify that you were able to read this electronic disclosure and that you also were able to print on paper or electronically save this page for your future reference and access or that you were able to e-mail this disclosure and consent to an address where you will be able to print on paper or save it for your future reference and access. Further, if you consent to receive notices and disclosures exclusively in electronic format on the terms and conditions described above, please let us know by clicking the 'I agree' button below. By checking the 'I Agree' box, I confirm that:  I am establishing my intent to be bound to the transaction, and indicating that I am fully aware of the purpose for which the signature is being provided.  I can access and read this Electronic CONSENT TO ELECTRONIC RECEIPT OF ELECTRONIC RECORD AND SIGNATURE DISCLOSURES document; and  I can print on paper the disclosure or save or send the disclosure to a place where I can print it, for future reference and access; and  Until or unless I notify Pitkin County as described above, I consent to receive from exclusively through electronic means all notices, disclosures, authorizations, acknowledgments, and other documents that are required to be provided or made available to me by Pitkin County during the course of my relationship with you. Signing Documents without a Pitkin County DocuSign Account: Pitkin County may not require all document signers to be authorized users of the Pitkin County DocuSign Account. Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agree to these terms and conditions, please confirm your agreement by clicking the 'I agree' button at the bottom of this document. When you don't have a DocuSign account, you will be provided the opportunity to agree to the Legal Disclosure each time you open an "envelope" for signing, at this time, you can download and retain this disclosure. Pitkin County will forward completed documents that you've reviewed, processed or signed via email. Should you require copies of these signed documents (e.g., if they get deleted from your email account) you should request those documents from Pitkin County under the Colorado Open Records Act by contacting the Pitkin County custodian who sent you the document for signature. Signing Documents with a Pitkin County DocuSign Account: Electronic Record and Signature Disclosure created on: 3/20/2020 3:28:13 PM Parties agreed to: Logan Hood, Kara Silbernagel Please read the information below carefully and thoroughly, and if you can access this information electronically to your satisfaction and agree to these terms and conditions, please confirm your agreement by clicking the 'I agree' button at the bottom of this document. Getting paper or electronic copies At any time, you may request from us a paper or electronic copy of any record provided or made available electronically to you by us. For such copies, as long as you are an authorized user of the DocuSign system you will have the ability to download and print any documents we send to you through your DocuSign user account for a limited period of time (usually 30 days) after such documents are first sent to you. After such time, if you wish for us to send you paper or electronic copies of any such documents from our office to you, you may be charged a per-page fee. You may request delivery of such paper or electronic copies from us by following the procedure described below. Withdrawing your consent If you are an authorized DocuSign Account holder, you can decide to receive notices and disclosures from us electronically, you may at any time change your mind and tell us that thereafter you want to receive required notices and disclosures only in paper format. Described below is the process for informing us of your decision to receive future notices and disclosure in paper format and also how to withdraw your consent to receive notices and disclosures electronically. Consequences of changing your mind If you elect to receive required notices and disclosures only in paper format, it will slow the speed at which we can complete certain steps in transactions with you and delivering services to you because we will need first to send the required notices or disclosures to you in paper format, and then wait until we receive back from you your acknowledgment of your receipt of such paper notices or disclosures. To indicate to us that you are changing your mind, you must withdraw your consent using the DocuSign 'Withdraw Consent' form on the signing page of your DocuSign account. This will indicate to us that you have withdrawn your consent to receive required notices and disclosures electronically from us and you will no longer be able to use your DocuSign user account to receive required notices and consents electronically from us or to sign electronically documents from us. All notices and disclosures will be sent to you electronically Unless you tell us otherwise in accordance with the procedures described herein, we will provide electronically to you through your DocuSign user account all required notices, disclosures, authorizations, acknowledgments, and other documents that are required to be provided or made available to you during the course of our relationship with you. To reduce the chance of you inadvertently not receiving any notice or disclosure, we prefer to provide all of the required notices and disclosures to you by the same method and to the same address that you have given us. Thus, you can receive all the disclosures and notices electronically or in paper format through the paper mail delivery system. If you do not agree with this process, please let us know as described below. Please also see the paragraph immediately above that describes the consequences of your electing not to receive delivery of the notices and disclosures electronically from us. How to contact Pitkin County: You may contact us to let us know of your changes as to how we may contact you electronically, to request paper copies of certain information from us, and to withdraw your prior consent to receive notices and disclosures electronically as follows: To contact us by email send messages to Helpdesk@provelocity.com To advise Pitkin County of your new e-mail address To let us know of a change in your e-mail address where we should send notices and disclosures electronically to you, you must send an email message to us at Helpdesk@provelocity.com and in the body of such request you must state: your previous e-mail address, your new e-mail address . In addition, you must notify DocuSign, Inc to arrange for your new email address to be reflected in your DocuSign account by following the process for changing e-mail in DocuSign. To request paper or electronic copies from Pitkin County To request delivery from us of paper or electronic copies of the notices and disclosures previously provided by us to you electronically, you should request those documents from Pitkin County under the Colorado Open Records Act by contacting the Pitkin County custodian who sent you the document for signature. To withdraw your consent with Pitkin County To inform us that you no longer want to receive future notices and disclosures in electronic format you may: i. decline to sign a document from within your DocuSign account, and on the subsequent page, select the check-box indicating you wish to withdraw your consent, or you may; ii. send us an e-mail to Helpdesk@provelocity.com and in the body of such a request, you must state your e-mail, full name, Postal Address, telephone number, and account number.