HomeMy WebLinkAbout129905 ELDERHAUS ADULT DAY PROGRAMS - CONTRACT - AGREEMENT MISC - ELDERHAUS ADULT DAY PROGRAMSR43500
CITY OF FORT COLLINS Purchase Order Date: 10/03/06
Purchase Order Print Page Number: 1
Purchase Order Number 6604789 - 000 - OP
Reference
Purchase Order number must appear on invoices, packing lists, labels, bills of lading, and all correspondence.
Vendor Number 129905 slehman@fc8 ov com
ELDERHAUS ADULT DAY PROGRAMS INC
605 S SHIELDS ST
FORT COLLINS CO 80521-3539
Requested Delivery: 08/01/06
Line Description / Supplier Item
1.000 1 LOT
Therapy Center Program
Total Order
Ship To ADVANCE PLANNING
CITY OF FORT COLLINS
281 N COLLEGE AVE
FORT COLLINS CO 80524-2404
Buyer STEPHEN, JOHN
Quantity UOM Unit Price Extended Price
LS .0000 16,920.00 101
City of Fort Collins Director of Purchasing and Risk Management
This order is not valid over $2000 unless signed by James B. O'Neill II, CPPO
City of Fort Collins Purchasing, PO Box 580, Fort Collins, CO 80522-0580
Phone: 970-221-6775 Fax: 970-221-6707 Email: purchasing@fcgov.com
16,920.00
Account Number
760300.529220 00000736
Mail Invoices in duplicate to:
City of Fort Collins
Accounting Department
PO Box 580
Fort Collins, CO 80522-0580
RECIPIENT SERVICE AGREEMENT
COMPETITIVE PROCESS: PUBLIC SERVICE CATEGORY
litakIYARIM1101111 111,11'
AN AGREEMENT, by and between the City of Fort Collins hereinafter referred to as
"City" and Elderhaus Adult Day Programs, Inc., hereinafter referred to as "Recipient", by which
the funding recipient agrees to carry out specific activities under the City's Human Services Program
(HSP) and establishing certain other terms and conditions of operation.
ARTICLE I. PROJECT
SECTION 1. SCOPE OF SERVICES
The City, in allocating Human Services Program monies from the General Fund, hereby
designates the Recipient to undertake, and the Recipient hereby agrees to undertake the activities
specifically described in its Competitive Process application and summarized below:
(A) General Statement
Elderhaus Adult Day Programs, Inc. will provide therapeutic services through the Elderhaus
Therapy Center Activity Program. The services provided will be in accordance with
Elderhaus Adult Day Programs, Inc.'s Spring 2006 Competitive Process proposal, and as
approved by City Council on May 16, 2006.
Human Services Program funds of $16,920 will be used to partially assist with the salaries of
2 out of 3 Program Directors/CNA's. Use of the funds is planned as follows:
• Salary #1 — 50%: 20 hours per week x $10.50 per hour x 48 weeks = $1 AO
• Salary #2 — 38%: 15 hours per week x $ 9.50 per hour x 48 weeks = $ 6,840
(B) Recipient Shall:
• Sustain a full service therapy center for higher energy adults with special needs.
• Assist disadvantaged and underserved families in overcoming geographic barriers and
financial restraint in meeting critical needs.
• Delay or avoid long-term placement of participants with special needs.
• Help caregivers to maintain employment and receive respite care.
• Collaborate with the Center for Neurorehabilitation Services, etc. to enhance and expand
program service offerings.
It is anticipated that approximately 45 unduplicated low-income clients will be served over
the course of this 12-month contract; 3 clients will be at the 0-30% AMI income level, 10
clients will be at the 31-50% AMI income level and 32 clients will be at the 51-80% AMI
income level.
Type of Project
Public Service
Funded Amount
$16,920
Fiscal Year: 2006
Project Location Population Served.
4825 S. Lemay Avenue, Fort Collins, CO 80525 Low Income Adults
SECTION 3. TERM OF AGREEMENT
The term of this Agreement is October 1, 2006 through September 30, 2007, but may be
extended should additional time for auditing this project be required, in accordance with law, this
Agreement shall be deemed automatically extended until such time as the said audit shall be
completed. Notwithstanding other provisions of this Agreement, the term of this Agreement shall
cover the period that the Recipient has control over Human Services Program funds.
SECTION 4. PROGRAM REPORTING
The Recipient shall submit such reports as required by the City to meet its local obligations
and regulations. The City will prescribe the report format, as well as the time and location for
submission of such reports. Required reports include but are not limited to the following:
(A) Quarterly reports which shall include the progress made to date, or justification for lack of
progress, in providing the services specified in Article 1, Section 1, Scope of Services, of this
Agreement.
(B) Quarterly reports on demographic and income information regarding persons assisted by the
Recipient through this Agreement.
(C) Close out reports including a final performance report and final financial report, upon
termination or completion of the award.
ARTICLE IL FINANCIAL CONDITIONS
SECTION 1. BUDGET AND COMPENSATION
The City shall reimburse the Recipient its allowable costs for the services identified in this
Agreement not to exceed Sixteen Thousand Nine Hundred Twenty Dollars ($16,920) upon
presentation of properly executed reimbursement forms as provided or approved by the City.
Such reimbursement shall constitute full and complete payment by the City under this
Agreement. Allowable costs shall mean those necessary and proper costs identified in the
Recipient's Competitive Process application and approved by the City unless any or all such costs are
disallowed by the State of Colorado.
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Any reimbursements made under this Agreement must comply with the applicable City
regulations. The Recipient may not request disbursement of funds under this Agreement until the
funds are needed for payment of eligible costs. The amount of each request must be limited to the
amount needed.
Budget Summary:
Time of Payment: Payment shall be made upon receipt of reimbursement request documents mailed
to: Human Services Program, Advance Planning Department, City of Fort Collins, P. O. Box
580 (281 North College Avenue), Fort Collins CO 80522-0580.
Where Payments Are Made: Payments shall be made to: Elderhaus Adult Day Programs, Inc.,
605 South Shields Street, Fort Collins, CO 80521.
The Recipient shall apply the funds received from the City under this Agreement in
accordance with the parameters outlined in Article I, Section 1, Scope of Services. Any line item
expense, by itself or in combination with any other line item expense change, equal to or greater than
10% of the total budget amount over the life of the Agreement shall require a formal amendment to
the Agreement. Any request for a line item expense, by itself or in combination with any other line
item expense change, equal to or less than 1.0% of the total budget amount shall be submitted in
writing and shall specifically state the reasons for the requested increase and a justification for the
corresponding decrease in other line item(s). All budget revision and/or amendment requests will be
reviewed and approved or denied by the City.
SECTION 2. DOCUMENTATION OF COSTS AND OTHER FINANCIAL REPORTING
All costs shall be supported by properly executed payrolls, time records, invoices, vouchers
or other official documentation, as evidence of the nature and propriety of the charges. All
accounting documents pertaining in whole or in part to this Agreement shall be clearly identified and
readily accessible, and upon reasonable notice, the City shall have the right to audit the records of the
Recipient as they relate to the work. The Recipient shall also:
(A) Maintain an effective system of internal fiscal control and accountability for all Human
Services Program (HSP) funds and property acquired or improved with HSP funds, and make
sure the same are used solely for authorized purposes.
(B) Keep a continuing record of all disbursements by date, check number, amount, vendor,
description of items purchased and line item from which money was expended, as reflected in
the Recipient's accounting records. The line item notations must be substantiated by a
receipt, invoice marked "Paid," or payroll record.
(C) Maintain payroll, financial, and expense reimbursement records for a period of five (5) years
after receipt of final payment under this Agreement.
(D) Permit inspection and audit of its records with respect to all matters authorized by this
Agreement by representatives of the City, or the State Auditor at any time during normal
business hours and as often as necessary.
(E) Inform the City concerning any funds allocated to the Recipient, that the Recipient anticipates
will not be expended during the Agreement period, and permit reassignment of the same by
the City to other Recipients.
(F) Repay to the City any funds in its possession at the time of termination of this Agreement that
may be due to the City.
SECTION 3. REIMBURSEMENT
The City shall reimburse the Recipient only for actual incurred costs upon presentation of
properly executed reimbursement forms approved by the City. Only those allowable costs directly
related to the Agency's Competitive Process application, approved by the City shall be paid
consistent with Article II, Section 2, Documentation of Costs and Other Financial Reporting. The
amount of each request must be limited to the amount needed for payment of eligible costs.
In the event the City determines any funds were expended by the Recipient for unauthorized
or ineligible purposes or the expenditures constitute disallowed costs in any other way, the City may
order repayment of the same. The Recipient shall remit the disallowed amount to the City within
thirty (30), days of written notification of the disallowance.
(A) The Recipient agrees that funds determined by the City to be surplus upon completion of the
Agreement will. be subject to cancellation by the City.
(B) The Recipient agrees that upon expiration of this Agreement, the Recipient shall transfer to
the City any HSP funds on hand at the time of expiration and any accounts receivable
attributable to the use of HSP funds.
(C) The City shall be relieved of any obligation for payments if funds allocated to the City cease
to be available for any cause other than misfeasance of the City itself.
(D) The City reserves the right to withhold payments pending timely delivery of program reports
or documents as may be required under this Agreement.
Use of any program income received by the Recipient as a result of, or in connection with,
Human Services Program funds shall be used for the current operation and benefit of the specific
program/project for which HSP funding was awarded.
ARTICLE III. GENERAL CONDITIONS
SECTION I. BENEFIT TO LOW INCOME PEOPLE
All Recipients providing direct benefit services shall provide such services to benefit
extremely low, very low, and low income persons to the maximum extent feasible (but not less than
51% of the persons receiving the service). Individual persons or families provided a specific direct
benefit or service must qualify under current income eligibility limits (% of AMI) as established by
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the Department of Housing and Urban Development (HUD). Any deviation can be made only if it is
clear that the service or benefit, to a person whose income exceeds very low and low income
persons, is otherwise necessary as an integral part of the activity. The Recipient shall maintain
records that clearly document the income range and household size of the persons it serves.
Furthermore, the Recipient shall maintain records documenting if the person being served is a female
head of household, and/or is an ethnic/racial minority.
SECTION 2.1 COMPLIANCE WITH LAWS
The Recipient, in performance of this Agreement, agrees to comply with all applicable
Federal, State and Local Laws and ordinances. Recipient agrees to comply with all provisions of the
Americans with Disabilities Act and all regulations interpreting or enforcing such act.
SECTION 2.2 COMPLIANCE WITH C.R.S. § 24-76.5-103 (11131023): Proof of Lawful
Presence
Recipient acknowledges that the City funds are a "public benefit" within the meaning of
C.R.S. § 24-76.5-103. As such, the Recipient shall ensure compliance with C.R.S. § 24-76.5-103 by
performing the required verifications. Specifically, when required the Recipient shall ensure that:
(A) If the public benefit provided by the funds flows directly to a natural person (i.e., not a
corporation, partnership, or other legally -created entity) 18 years of age or older, he/she must
do the following:
(1) Complete the affidavit attached to this Agreement as Exhibit A.
(2) Attach a photocopy of the fi-ont and back of one of the following forms of
identification: a valid Colorado driver's license or Colorado identification card; a
United States military card or military dependent's identification card, a United States
Coast Guard Merchant Mariner identification card; or a Native American tribal
document.
(B) If an individual applying for the benefits identified herein executes the affidavit stating that
he/she is an alien lawfully present in the United States, Recipient shall verify his/her lawful
presence through the federal systematic alien verification or entitlement program, known as
the "SAVE Program," operated by the U.S. Department of Homeland Security or a successor
program designated by said department. In the event Recipient determines through such
verification process that the individual is not an alien lawfully present in the United States, the
Recipient shall not provide benefits to such individual with City funds.
City acknowledges that the Scope of Services provided by Recipient herein may fall within
several exceptions to the verification requirements of C.R.S. § 24-76.5-103 for non -profits. For
example, certain programs, services, or assistance such as, but not limited to, soup kitchens, crisis
counseling and intervention, short-term shelter or prenatal care are not subject to the verification
requirements of C.R.S. § 24-76.5-103.
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SECTION 2.3 COMPLIANCE WITH C.R.S. § 8-17.5-101 (1113 1343): Prohibition Against
Employing Illegal Aliens
Recipient represents and agrees that:
(A) As of the date of this Agreement:
(1) Recipient does not knowingly employ or contract with an illegal alien; and
(2) Recipient has participated or attempted to participate in the basic pilot employment
verification program created in Public Law 208, 104th Congress, as amended, and
expanded in Public Law 156, 108th Congress, as amended, administered by the
United States Department of Homeland Security (the "Basic Pilot Program") in order
to verify that Recipient does not employ any illegal. aliens.
(B) Recipient shall not knowingly employ or contract with an illegal alien to perform works under
this Agreement or enter into a contract with a subcontractor that fails to certify to Recipient
that the subcontractor shall not knowingly employ or contract with an illegal alien to perform
work under this Agreement.
(C) Recipient shall continue to apply to participate in. the Basic Pilot Program and shall in writing
verify same every three (3) months thereafter, until Recipient is accepted or the public
contract for services has been completed, whichever is earlier. The requirements of this
section shall not be required or effective if the Basic Pilot Program is discontinued.
(D) Recipient is prohibited from using Basic Pilot Program procedures to undertake pre-
employment screening of job applicants while this Agreement is being performed.
(E) If Recipient obtains actual knowledge that a subcontractor performing work under this
Agreement knowingly employs or contracts with an illegal alien, Recipient shall:
(1) Notify such subcontractor and the City within three (3) days that Recipient has actual
knowledge that the subcontractor is employing or contracting with an illegal alien;
and
(2) Terminate the subcontract with the subcontractor if within three (3) days of receiving
the notice required pursuant to this section the subcontractor does not cease
employing or contracting with the illegal alien; except that Recipient shall not
terminate the contract with the subcontractor if during such three (3) days the
subcontractor provides information to establish that the subcontractor has not
knowingly employed or contracted with an illegal alien.
(F) Recipient shall comply with any reasonable request by the Colorado Department, of Labor
and Employment (the "Department") made in the course of an investigation. that the
Department undertakes or is undertaking pursuant to the authority established in Subsection
8-17.5-102 (5), C.R.S.
(G) If Recipient violates any provision of this Agreement pertaining to the duties imposed by
Subsection 8-17.5-102, C.R.S. the City may terminate this Agreement. If this Agreement is
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so terminated, Recipient shall be liable for actual and consequential damages to the City
arising out of Contractor's violation of Subsection 8-17.5-102, C.R.S.
(H) The City will notify the Office of the Secretary of State if Recipient violates this provision of
this Agreement and the City terminates the Agreement for such breach.
The Recipient shall comply with Executive Order 11246 as amended by Executive Order
12086 and the regulations issued pursuant thereto (41 CFR Chapter 60) will not discriminate against
any employee or applicant for employment because of race, color, creed, religion., ancestry, national
origin, sex, disability or other handicap, age, marital status, or status with regard to public assistance.
The Recipient will take affirmative action to ensure that all employment practices are free from such
discrimination. Such employment practices include but are not limited to the following: hiring,
upgrading, demotion, transfer, recruitment or recruitment advertising, layoff, termination, rates of
pay or other forms of compensation and selection for training, including apprenticeship.
The Recipient agrees to post in conspicuous places, available to employees and applicants for
employment, notices setting forth the provisions of this nondiscrimination clause. The Recipient will,
in all solicitations or advertisements for employees placed by or on behalf of the Recipient, state that
it is an Equal Opportunity or Affirmative Action Employer.
Where employees are engaged in activities not covered under the Occupational Safety and Health
Act (OSHA) of 1970, they shall not be required or permitted to work, be trained or receive services in
buildings or surroundings or under working conditions which are unsanitary, hazardous or dangerous to
the participants' health or safety.
SECTION 4. DISCRIMINATION PROHIBITED
The Recipient shall not, on the grounds of race, color, sex, religion, national origin, creed,
marital status, or age:
(A) Deny a qualified individual any facilities, financial aid, services or other benefits provided
under this Agreement;
(B) Provide any facilities, services, financial aid, or other benefits which are different, or are
provided in a different manner, from those provided to others under this Agreement;
(C) Subject an individual to segregated or separate treatment in any facility in, or in any matter if
process related to receipt of any service or benefit under this Agreement;
(D) Restrict an individual in any way in access to, or in the enjoyment of any advantage or
privilege enjoyed by others in connection with any service or benefit under this Agreement,
(E) Treat anyone differently from others in determining if they satisfy any admission, enrollment,
eligibility, membership or other requirement or condition which the individual must meet to
be provided a service or benefit under this Agreement;
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(F) Deny anyone an opportunity to participate in any program or activity as an employee which is
different fi•om that afforded others under this Agreement.
No member, officer, or employee of the Recipient, or its designees or agents, no member of
the governing body of the City of Fort Collins, and no other public official, employee, or Board or
Commission member of the City of Fort Collins, who exercises any function or responsibilities with
respect to the program during his tenure or for one (1) ypar thereafter, shall have any interest, direct
or indirect, in this Agreement or any Subagreement, hereto or the proceeds thereof. Any potential
conflict on the part of any of these parties shall be disclosed to representatives of the City's Advance
Planning Department or the City's Attorney's Office.
SECTION 6. SEPARATION OF CHURCH AND STATE
In addition to, and not in substitution for, other provisions of this Agreement regarding the
provision of services utilizing Human Services Program funds the Recipient agrees that, in
connection with such services:
(A) It will not discriminate against any employee or applicant for employment on the basis of
religion and will not limit employment or give preference in employment to persons on the
basis of religion;
(B) It will not discriminate against any person applying for such public services on the basis of
religion and will not limit such services or give preference to persons on the basis of religion;
(C) It will provide no mandatory religious instruction or counseling, conduct no religious worship
or services, engage in no religious proselytizing, and exert no other religious influence in the
provision of such services;
The Recipient agrees to comply with and to obtain at its own expense, if necessary, all
applicable Federal, State, County or Municipal standards for licensing, certification and operation of
facilities and programs, and accreditation and licensing of individuals, and any other standards or
criteria as described in the Agreement to assure quality of services.
In the event of an investigation or suspension regarding any licensing related to the services
for which the City is providing funding under this Agreement, the City may terminate this Agreement
and withhold all further Agreement funds. In addition, monies already received under the terms of
this Agreement, may be owed back to the City. The City may also declare the Recipient ineligible for
any further participation in City Human Services Program, Community Development Block Grant
(CDBG), HOME Investment Partnership, or Affordable Housing Fund Agreements.
The Recipient agrees to defend, indemnify and save harmless the City, its appointed and
elected officers and employees from and against any and all liability, loss, costs, damage and expense,
including costs and attorney fees in defense thereof because of actions, claims or lawsuits for
damages resulting from personal or bodily injury, including death at any time resulting from there,
sustained or alleged to have been sustained by any person or persons and on account of damage to
property, arising or alleged to have arisen directly or indirectly out of or in consequence of or the
performance of this Agreement, whether such injuries to persons or damage to property is due to the
negligence of Recipient, its subcontractors, agents, successor, assigns. This provision shall be
inapplicable to the extent the City is judicially found solely negligent for such damage or injury.
SECTION 9. NOTICES
Any notices required to be given by the City to the Recipient or by the Recipient to the City
shall be in writing and delivered to the following parties at the following addresses:
City:
Human Services Program
Advance Planning Department
City of Fort Collins
PO Box 580 (281 N. College - 80524)
Fort Collins CO 80522-0580
Recipient:
Elderhaus Adult Day Programs, Inc
605 South Shields Street
Fort Collins CO 80521
SECTION 10. CITIZEN AND CLIENT PARTICIPATION
The Recipient will have processes in place (satisfaction surveys, board representation,
grievance procedures, etc.) which receive, document and utilize the input from low-income persons
potentially benefiting or affected by the program or project covered under this Agreement.
The Recipient shall not assign or subcontract any portion of the services provided within the
terms of this Agreement without obtaining prior written approval from the City. All terms and
conditions of this Agreement shall apply to any approved subcontract or assignment related to the
Agreement.
SECTION 12. RESERVATION OF RIGHTS
Failure to insist upon strict compliance with any terms, covenants or conditions of this
Agreement shall not be deemed a waiver of such, nor shall any waiver or relinquishment of such right
or power at any time be taken to be a waiver of any other breach.
The parties hereby further agree that this Agreement cannot be amended or modified without
the written concurrence of both parties.
Ka 9 MOIKEM DEI I R N• •
In the event of a failure by the Recipient to comply, with any terms or conditions of this
Agreement or to provide in any manner the activities or other performance as agreed to herein, the
City reserves the right to temporarily withhold all or any part of payment pending correction of the
deficiency, suspend all or part of the Agreement, or prohibit the Recipient from incurring additional
obligations of funds until the City is satisfied that corrective action has been taken or completed.
The option to withhold funds is in addition to, and not in lieu of, the City's right to terminate as
provided in the General Conditions, Article III, Section 15, Termination, of this Agreement. The
City may consider performance under this Agreement when considering future awards.
If the Recipient fails to comply with the terms and conditions of this Agreement, the City may
pursue such remedies as are available, including but not limited to, the termination of this Agreement
in the manner specified herein.
(A) Termination for Cause - If the Recipient fails to comply with the terms and conditions of this
Agreement and any of the following conditions exist:
(1) The lack of compliance with the provisions of this Agreement are of such scope and
nature that the City deems continuation of this Agreement to be substantially non -
beneficial to the public interest;
(2) The Recipient has failed to take satisfactory corrective action as directed by the City
or its authorized representative within the time specified by same-,
(3) The Recipient has failed within the time specified by the City or its authorized
representative to satisfactorily substantiate its compliance with the terms and
conditions of this Agreement.
The City may terminate this Agreement in whole or in part, and thereupon shall notify in
writing the Recipient of the termination, the reasons therefore, and the effective date. The effective
date shall not be prior to notification of the termination by the City to the Recipient. Costs resulting
from obligations incurred by the Recipient after termination of the Agreement are not allowable
unless specifically authorized in writing by the City.
(B) Termination for Convenience - The award may be terminated for convenience, in whole or in
part, as follows:
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(1) By the City with the consent of the Recipient. The two parties shall agree upon the
termination conditions, including the effective date and in the case of partial
termination, the portion to be terminated, or
(2) By the Recipient upon submitting written notification to the City. The written
notification must set forth the reasons for the termination, the effective date, and in
the case of partial termination, the portion to be terminated. However, in the case of
a proposed partial termination, the City may terminate the award in its entirety if the
City determines that the remaining portion will not accomplish the purpose for which
the award was made.
(C) Termination for, Withdrawal, Reduction or Limitation of Funding
(1) In the event that funding is withdrawn, reduced or limited in any way after the
effective date of this Agreement, and prior to its normal completion, the City may
summarily terminate this Agreement as to the funds reduced or limited,
notwithstanding any other termination provision of this Agreement. If the level of
funding so reduced or limited is so great that the City of Fort Collins deems that the
continuation of the program covered by the Agreement is no longer in the best
interest of the public, the City may summarily terminate this Agreement in whole
notwithstanding any other termination provisions of this Agreement. Termination
under this Section shall be effective upon receipt of written notice by the Recipient or
its representative.
SECTION 16. CLOSE-OUT
Upon termination of this Agreement, in whole or in part for any reason including completion
of the project, the following provisions shall apply:
(A) Upon written request by the Agency, the City shall make or arrange for payment to the
Recipient of allowable reimbursable costs not covered by previous payments.
(B) The Recipient shall submit within thirty (30) days after the date of expiration of this
Agreement, all financial, performance and other reports required by this Agreement, and in
addition, will cooperate in a program audit by the City or its designee.
(C) Close-out of funds will not occur unless all outstanding issues with the general contractor and
or subcontractor have been resolved to the satisfaction of the City.
SECTION 17. VENUE AND CHOICE OF LAW
If either party to this Agreement initiates any legal or equitable action to enforce the terms of
this Agreement, to declare the rights of the parties under this Agreement, or which relates to this
Agreement in any manner, the City and the Recipient agree that the proper venue for such action is
the Larimer County, Colorado, District Court. It is mutually understood and agreed that this
Agreement shall be governed by the laws of the State of Colorado, both as to interpretation and
performance.
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It is understood and agreed by the parties that if any part, tern, or provision of this
Agreement is held by the courts to be illegal or in conflict with any law of the state where made, the
validity of the remaining portions or provisions shall not be affected, and the rights and obligations of
the parties shall be construed and enforced as if the Agreement did not contain the particular part,
term, or provision held to be invalid.
•\_V 01 ),IT
This Agreement with any attachments, and the Recipient's corresponding application for the
City's Competitive Process, incorporated by reference, constitute the entire agreement between the
parties and both parties acknowledge that there are no other agreements, written or oral, that have
not been fully set forthin the text of this Agreement.
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IN WITNESS WHEREOF, the parties have executed this Agreement as of the date of the most
recent signatory.
Date:
A
City Clerk
r -r ,
F
Deputy C
Date:
Board Secretary
(Corporate Seal)
THE CITY OF FORT COLLINS, COLORADO
A Municipal Corporation
By:
Darin A. Atteber y, City Manager
RECIPIENT:
Elderhaus Adult Day Programs, Inc.
By: _6_)Vfj,,"�
Paul W lson, .. hair, Board of Directors
By:r
�Jonne Johnsen xe utive Director
FederafT.D. #: 84-0833808
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