HomeMy WebLinkAbout2022-593-E-Health-Awakenings Counseling-Amendment to Service Agreement EMDR Therapy FacilliationRevised 06/21
NORTH CAROLINA
CONTRACT AMENDMENT
ORANGE COUNTY
THIS CONTRACT AMENDMENT (“Amendment”) is made and entered into this 1st day of November, 2022 by and
between ORANGE COUNTY (hereinafter referred to as “County”) and Awakenings Counseling, LLC (hereinafter
referred to as “Provider”).
WITNESSETH:
THAT WHEREAS, the County and Provider entered into a contract dated August 22, 2022, (hereinafter the “Original
Agreement”), for the provision of services for Facilitate participation in clinical consultation group about EMDR therapy;
and
WHEREAS, the County and Provider desire to amend the Original Agreement while keeping in effect all terms and
conditions of the Original Agreement not inconsistent with the terms and conditions set forth below.
NOW THEREFORE, for and in consideration of the mutual covenants and agreements made herein, the parties agree to
amend the Original Agreement as follows:
1. In order to ensure the completion of the Services identified in the term of the Original Agreement is amended
to reflect an end date by which all Services shall be completed of June 30, 2022.
2. Except for the changes made herein, the Original Agreement shall remain in full force and effect to the extent
it is not inconsistent with this Amendment. In the event there is a conflict between the terms of the Original
Agreement and the terms of this Amendment, this Amendment shall control.
IN TESTIMONY WHEREOF, this Amendment has been executed by the parties hereto, as of the date first above
written.
ORANGE COUNTY PROVIDER
______________________________ __________________________________
Quintana Stewart Linda Ouellette, LPC
Health Director Awakenings Counseling, LLC
DocuSign Envelope ID: B2566E80-2C07-49D8-B7AF-8975E30F7430
Revised 06/21
ORANGE COUNTY—DEPARTMENT USE ONLY
______________________________________________________________________________
Party/Vendor Name: Awakenings Counseling, LLC Party/Vendor Contact Person: Linda Ouellette Contact Phone: 520-977-7045
Party/Vendor Address: 5151 N. Oracle Rd., Ste. 118C City Tucson State: AZ Zip: 85704 Department: Health Amount: $0 Purpose:
Amendment to Service Agreement EMDR Therapy Facilliation Budget Code(s): 10414020-630000-71400 Vendor # 67677 (N/A if
new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment
Effective Date 11-1-22 Approved by Board Yes No Agenda Date: --- For Section XIV. c. contracts only, Approved by
Board in Current FY Budget Yes No
This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this pro ject has
not been initiated prior to execution of the agreement:
Department Director’s Signature ________________________________________ Date: ________
Agreements for emergency services or repair are not subject to the above affirmation. If servic es related to this agreement have
already begun or been completed please briefly describe the nature of the emergency condition that was addressed:
Information Technologies
(Applicable only to hardware/software purchases or related services) This agreement has been reviewed and is approved as to
information technology content and specifications:
Office of the Chief Information Officer___________________________________ Date: ________
Risk Management
This agreement is approved for sufficiency of insurance standards, specifications, and requirements:
Office of the Risk Management Officer ___________________________________ Date: _________
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer ____________________________________ Date: _________
Legal Services
This agreement is approved as to legal form and sufficiency:
Office of the County Attorney __________________________________________Date: ________
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountync.gov
The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board __________________________________________Date:_________
DocuSign Envelope ID: B2566E80-2C07-49D8-B7AF-8975E30F7430
11/10/2022
11/10/2022
11/11/2022
11/13/2022
�m ALLI ED ALLTEU WORLD INSURANCE COMPANY O 23 WOR LC A stock insurance company, incorporated under the laws or New Hampshire • ......,..,_ 1690 New Britain Al'enoe, Suite 101, Farmington, CT 06032 (1-800-421-6694)
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NOTICE: A LOWER l.Thtn' OF LlABII.JTV APPLIES TO JUDGEMENTS OR SETTLEMENTS WIIFJ'ITHERE ARE ALI.EOATIONS OF SEXUAL MISmNDUcr
(SEE THE SPECIALPROVlSlO!ol'SEXUAL MISCONDIJCI"' INTIIE POLICY).
D RATION
POLICY N O: 5003-6071 ACCOUNTNO: AZ-AWAK515-0 0570442R ITEM I. (•) NMIBAND ADDRESS OF INSURED: ITEM I. (b) ADDIDONAL NAMFD INSUREDS:
ITEM 2.
ITEM3.
ITEM4.
JTEM5
ITEM6
ITl!M7.
ITEMS.
AWAKENINGS COUNSELING LLC 5151 N ORACLE RD STE 118C TUCSON, AZ 85704
ADDmONAL JNSIJREDS:
TYPEOF ORG:
LINDA C. OUELLETTE
LLC/LLP
POLICY PERIOD: FROM: . 02/01/22 TO: 02/01/23
12:0lA.M. STANDARD TIME ATTIIE AODRESS OF THE INSURED AS STATED HEREIN:
LIMITS OF UABO..ITY:
(aJS, ___ l....:....' _0_0_0.:..,_0_0_0_ PER-CLAIM'-1NSURING AGREEMENT A.(c)$
(bJs, __ ..... 1..,._.o'-'o'-'o"'"._,.o"'o"'o_ PER-CLAIM-INSURING AGREEMENT 8.0) and 8.(2) (d) S PREMIUM SOIEDULE: CLASSIFlCATION NUMBER RATE
COONSELOR
3,000,000 'AGGREGATE
50.000 PER PROCEllDING
ANNUAL PREMIUM
SELF-EMPLOYED PROFESSIONAL 1 DEFENSE LIMIT .
RETROACTIVE DA TE: 02/01/14 TOT AL PREMIUM:
EXTENDED REPORTING PERIOD
ADDIDONAL PREMIUM r,r eurciscd):S, ___L---
POLICY FORMS AND ENDORSEMEN'IS A TT ACHED TO THIS POLICY
APA-MH 00002 00 (06/14) APA 00127 02 (06/14)
APA-MH 00001 00 (06/14)
T8IS rs NOT A BILL PRF.�nul\l HAS DEEN PAID. AUTHORJZEO COMPANY REPRESENTATIVE
A.mcqan Professinn31 Ageocy • 95 Bro.:u:IWG)', Amityville. NY t l?OI
DocuSign Envelope ID: B2566E80-2C07-49D8-B7AF-8975E30F7430