PBM Contract and Amendment - nastad

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PO/SC ENCUMBRANCE NUMBER: PO FHA EPI1011185 BILLING STATEMENTS RECEIVEI):. T'ERM: Monthly -. This contract shall be effe
DEI' ARTMENT OR AGENCY NAME

COLORADO DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT DCEED-RW

DEPARTMENT OR AGENCY NU.YIBER

FHA CONTRACT ROUTING NUMBER

12-40885 CONTRACT AMENDMENT # 2 This Contract Amendment is made this

2,l!! day

of February, 2012, by and between the State of Colorado, acting by

and through the DEPARTMENT OF PUBLIC HEALTH AND ENVIRONMENT, whose address or principal place of business is 4300 Cherry Creek Drive South, Denver, Colorado 80246, hereinafter referred to as the "State"; and, Ramsell Public Health Rx, LLC., (Limited Liability Companv), whose a ddress or principal place of business is 200 Webster Street, Oakland, CA 94607, hereinafter referred to as the "Contractor".

FACTUAL RECITALS The parties entered into a contract dated March 1, 2010, with contract encumbrance number PO FHA EP1I 011l85

,

and contract routing number 10 FHA 11185, whereby the Contractor was to provide to the State the following:

The Contractor shall provide the services for the Acq uired Immune Deficiency Syndrome (AIDS) Drug Assistance Program (ADAP). The State promises to pay the Contractor the sum of Eight Hundred Fifteen Thousand, Seven Hundred Sixty Eight Dollars, ($815,768.00) in exchange for the promise of the Contractor to continue to perform the work identified in the Original Contract for the renewal term of one year, ending on March 31,2013.

NOW THEREFORE. in consideration oftheir mutual promises to each other, stated b elow, the parties hereto agree as

follows:

I.

Consideration for this Contract Amendment to the Original Contract consists of the payments and services that shall be made pursuant to this Contract Amendment, and promises and agreements herein set forth.

2.

It is expressly agreed to by the parties that this Contract Amendment is supplemental to the original contract, contract routing number 10 FHA 11185,a s amended by Contract Amendment #1, routing

number 11 FHA 29748 collectively referred to herein as the Original Contract, which is by this reference incorporated herein. All terms, conditions, and provisions thereof, unless speeifically modified herein, are to apply to this Contract Amendment as though they were expressly rewritten, incorporated, and included herein. 3.

It is expressly agreed to by the parties that the Original Contract is and shall be moditled, altered, and changed in the following respects only: A.

This Contract Amendment is issued pursuant to paragraph!ยง:.o f the Original Contract identified by contract routing number 10 FHA 11185. This Contract Amendment is for the renewal term of

April 1, 2012, through and including March 31, 2013. The maximum amount payable by the Slate for the work to be performed by the Contractor during this renewal term is Eight Hundred Fifteen Thousand, Seven Hundred Sixty Eight Dollars, ($815,768.00) for an amended total financial obligation ofthe State of ONE MILLJO , SIX HUNDRED SEVENTY FIVE THOVSAND, FIVE HUNDRED EIGHTY EIGHT DOLLARS, ($1,675,588.00). This is an increase of Eight Hundred Fifteen Thousand, Seven Hundred Sixty Eight Dollars, ($815,768.00) of the amount payable from the previous term. The revised specifications to the Budget, if any, for this renewal term are incorporated herein by this reference and identified as

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Rev 03/16/2010

"Exhibit G". The Original Contract is modi fied accordingly. All other terms and conditions ofthe Original Contract are reaffirmed. 4.

The effective date ofthis Contract Amendment is Aorill, 2012, or upon approval ofthe State Controller, or an authorized delegate thereot whichever is later.

5.

Except for the General Provisions and Special Provisions of the Original Contract, in the cvent of any conflict, i neonsistency, variance, or contradiction between the terms and provisions ofthis Contract Amendment and any ofthe terms and provisions of the Original Contract, the terms and provisions of this Contract Amendment shall in all respects supersede, govern, and control. The Special Provisions shall always control over other provisions of the Original Contract or any subsequent amendments thereto. The representations in the Special Provisions to the Original Contract concerning the absence ofpersonal interest of state of Colorado employees is presently reaftirmcd.

6.

FINANCIAL OBLIGATIONS OF THE STATE PAYABLE AFTER THE CURRENT FISCAL YEAR ARE CONTINGENT UPON FUNDS FOR THAT PURPO SE BEING A PP ROPRIATED. BUDGETED, AND OTHERWISE MADE AVAILABLE.

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Rev 0311 6/20 I 0

IN WITNESS WHEREOF, the parties hereto have executed this Contract Amendment on the day first above written.

*

Persons signing for Contractor hereby swear and affirm that they are authorized to act on Contractor's behalf and acknowledge that the State is relying on their representations to that effect.

CONTRACTOR:

STATE:

Ramsell Public Health Rx, LLC.

STATE 0.1