85-1702 WHITE - C�TV GLERK
PINK - FINANCE G I TY OF SA I NT PAU L Council
CANARY - DEPARTMENT +/�
BLUE - MAVOR Flle NO• S- �/ O�
Council Resolution
Presented y "� ci '%�
Referred To r I ►�l� L-� Committee: Date 1���+L'��
Out of Committee By Date
RESOLVED, that the proper City officials are hereby authorized
and directed to execute an agreement with the County of Ramsey
and Urban Indian Health Clinic whereby the City and County
provide funding to Urban Indian Health Clinic, subject to the
terms and conditions of said agreement, a copy of which is to be
kept on file and of record in the Department of Finance and
Management Services.
COUfVCILMEN � Requested by Department of:
Yeas p�� Nays
nnasanz Community Services
�� In Favor
Scheibel -CL � �
Sonnen Against Y —Tr���—=r '
Tedesco �
W i Ison
Adopted by Council: Date oE� 2 � �u� Form A roved y Cit tt ne
�
�
Certified Pa_ by Council S etar � BY �
By
A►pprov y A�favor: Date � 2 7 F7VJ Approved by Mayo r S bmiss to Council
By
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. �• . . . - • jF �J���Q�.
t_
AGREEMENT
AN AGREEMENT, made and entered into this day of ,
�
198 .� among the City of Saint Paul, a municipal corporation of the
State of Minnesota, hereinafter referred to as the "City", acting
through its Division of Public Health; the County of Ramsey, a political
subdivision of the State of Minnesota, hereinafter referred to as the
"Countg", acting� through its Department of Health; and St. Paul Urban
Indian Health Board, Inc. located at 301 Fuller Avenue, Saint Paul,
Minnesota, hereinafter called "Grantee";
WITNESSETS: '
In consideration of the Grantee functioning as a neighborhood
health center in caring for the medical-health needs of the citizens of
Ramsey County, the parties hereto mutually agree as follows:
1. The City and County will each give to the Grantee the sum of
money described in attachment A, and according to the Manner and
conditions described in. attachment A.
2. The sum of money granted by the City and County is for the
Grantee's use during 1986. No additional or future funding or
assurances thereof will be provided or honored unless set forth in an
amendment to this Agreement or a separate agreement approved as the free
act of the City and County. The City and County may, upon 30 days '
written notice, reduce the amount of funding.
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3. The City and the County will each act as independent
transmittal agents for their contributions to the Grantee.
4. The Grantee shall on April 20, 1986, July 20, 1986, October 20,
1986 and January 20, 1987 submit to the City and County an itemized
statement of all Grantee revenue and expenditures; and a report of
services shown as attachment B. Further the Grantee shall preserve all
,
documentation used by it in complying with the statements and reports
required of this paragraph and such documentation shall be available to
the City and County for their review and audit as desired.
%, -
5. The Grantee shall, with approval of the City, enforce a fee
schedule for patient charges. Said fee schedule shall be made available
to the City on January 15, 1986.
6. The City shall act as the liaison to the Grantee for such
day-to-day administration as may be needed and shall be responsible for:
(a) Reviewing and evaluat.ing the program and fiscal activities
of the Grantee and disseminating reports thereof;
(b) Coordinating activities common to the Division of Public
Health of the City and/or the Public Health Department of
the County and the Grantee;
(c) Rendering to the Grantee such other assistance as within
the City's resources.
7. The Grantee shall ensure that:
(a) Services provided to eligible individuals are furnished
without regard to race, color, creed, sex, age, anarital
status or family size;
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' (b) Services are provided with respect for individuals privacy
and dignity; and;
(c) Services are provided without coercion and shall not be
denied on the basis of refusal ta participate in research
projects or other activities of the Grantee, or in an
emergency situation on the basis of ability to pay.
8. The Grantee shall submit to the City and to the County on or
before February 1, 1986 an operational plan of its services to be
provided during the term of this Agreement. Such operation plan shall
show expected service volume by clinic visits and number of users by
program areas.
9. The Grantee shall attach to this Agreement prior to its
execution by the City and the County a 1986 operational budget to
include Revenue and Expenses.
10. The Grantee sha11 obtain a financial and program audit by a
certified public accountant. This audit shall cover the Grantee's most
recent fiscal year ending during the term of this agreement. The
Grantee shall submit a copy of the audit report to the City and County
by April 1, 1987.
11. By April 1, 1986 the Grantee shall submit a narrative which
highlights present status and/or future actions to be undertaken
concerning quality assurance. The report shall cover such items as
those identified in the Metro Community Health Consortiums Minimum
Standards for Ooeration of a Community Clinic.
12. The Grantee shall make available relevant background and
qualification summaries, job descriptions and salary levels of both
regularly employed and volunteer staff to the City and the County.
3
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.� - . _ . . . . _ - - --- -- - _ _ _ �.���_�:�-�-_-_-._-._ -�-�_ - - - -_. ,- __ _--}
, _ _ . _ . _ _
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• . • • � /�/7l�s�
� 13. The Grantee shall submit to the City and the County the minut�s
from its monthly board meetings .
14. The Grantee agrees that deviations of ten percent (10�) or
more, upwards or downwards, from its 1986 agency budget, and/or
additions or deletions from its 1986 operational plan as approved by the
City and County will be transmitted to the City and County in a timely
fashion and in a manner to be determined by the City's clinic
� .
coordinator. Such information shall be before the fact and shall
include pertinent data relative to the planned addition, deletion, or
any other modification of programs and the subsequent projected.
budgetary impact for the contract year �d- the following year.
15. The Grantee declares Martha Havican to be the person
responsible for compliance with the terms of the Agreement, and its
physician, Carolyn Levitt, MD, as the person responsible for its medical
services.
16. The City declares its Director of the Department of Community
Services or such designee as noted in writing by her as the person
responsible for compliance with.. this Agreement.
17. The County declares its Executive Director or such designee as
noted in writing by him as the person responsible far compliance with
this Agreement.
18. The parties to this Agreement intend that the relation between
them created by this Agreement is that of Grantor-Grantee. The City
and County is interested only in the results to be achieved. The manner
and means of conducting the work are under the control of the Grantee,
except to the extent they are limited by statute, rule or regulation and
the express terms of the Agreemeat.
4
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19. No Civil Service status or other rights of employment will be
= acquired by virtue of the Grantee 's services.
20. From any fees due the Grantee there will be no deductions for
any federal income tax or FICA payments, nor for any state income tax,
nor for any other known purposes which are associated with an
employer-employee relationship unless required by law. Payment of
federal income tax, FICA payments and state income tax are the
responsibility of the Grantee in relationship to its employees.
21. The Grantee will defend, hold harmless and pay on behalf of the
County ot Ramsey and the City of St. Paul, its officials and employees
any demands, claims or suits arising out of the Grantee's premises or
performance of this contract.
22. Grantee shall obtain and attach certificate of insurance to
signed cqntract for:
Comprehensive General Liability insurance policy with contracting
departments, County of Ramsey, and City of Saint Paul, its'
officials and employees as additional assureds. Policy will have
minimum limits of $600, 000 per occurrence, $1, 000, 000 aggreqate.
Coverage pertains to operation and premises of contractor.
Automobile Liability insurance, including non-owned and hired autos.
Minimum limits of $600,000 combined single limits.
Workers ' Compensation
Professional Liability insurance in the minimum amount of $600,000
per claim and $1,000, 000 aggregate. The County of Ramsey and City
of Saint Paul, contractinq department and officials and employees
are additional assureds as to the serviees of the contractor.
5
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_ .
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_ _ _. .. _ �,'.--.,.. �-- -
�'� . . . . . �i= �.� o���
23. This Agreement may be terminated by either party with or
without cause upon 30 days ' written notice.
24. The term of this Agreement shall be from January 1, 1986
through December 31, 1986.
IN WITNESS WHEREOF, the parties have set their hands as follows:
CITY OF SAINT PAUL COUNTY OF RAMSEY
Activity code: 03232 Recommend Approval:
�
Mayor ' Department Director
Funds are available
Account Number
�,Director, Department of Finance �Aanount:
if�!' and Management Services .
:=�� q a��.. �{►�. ' Budgeting and Accounting
Director, Department of
Community Services Insurance Approved:
App ved as to form:
� Risk Manager
� �
G
Assistant City Attorney Approved as to form:
GRANTEE Assistant County Attiorney
- � . �C/ l
�` Board Chairman
By:
Chief Clerk-County Board
� ,�,��'.u,c�..c� G���-!i
6
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ATTACHMENT A
St. Paul Urban Indian Health Board Inc.
1986 City Contribution $ 27,562
1986 County C�ntributions $ 27,085
The City and the County shall each pay to the Grantee their
cantributions in equal monthly installments on or before the first day
of each month.
I
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301 FULLER AVENUE ��rrE= C F
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TiONS 0=SU�:H POLI�IES. ' �
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CZTY OF ST. PAUL, COUlCTY OF RA.*iSEX�, THEIR CONTRACTIVG DEPp,RTT•�PITS, OFFICIALS AI�D E�iPIAYEES
�ARc tiAt�D AS ADDITIOVAL INSUREDS Wi DER COt•IPP.EiIENSIVE GEhERAI. LI.'iBILITY BIIT Oh'LY AS pERTAIlYS
TO CLAZrLS ARISING OUT OF OPERATI{h�S OF NAt•i�D INSURED.
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� 555 CEDAR STREET -��� °��H�'��'N DATE. 'ihcR-OF, THE tSSii4NG CCi;APAKY V/t_t _Y�EAYOR TO
:`: AIAlL_�_ ._Op`�S '.LRTT�:ti{�:OTtC�70 T�E C�ATIFtCA°=hC.:^_�NANED TO 7yE
,j ST. PAUL, ��. 55101 �` 'ET.EUT F?il.l'?F i�����I`:;'_i:!1!'vT;CE SH6..�Lll�P058 KO Ci9itC.A':O"i'�A LL'19iLtTY
�ATT: G.ARY PECKMe►N ���GF d!:'r K:tv7=�O�; r_� =?�ADtY �?S tiGtN?S OR°�P?:.�FVT4?_;•'3.
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"'_ ... . _ IMSURED COPY M SB W�!0 6 02411-8b �
� ' � :+:. .:� i:�:,iii;d_ 1NS �0 WORKERS COMPENSATIUN ANO
.. i:3:; �;.�SFiti�::,;;;fJ ST. EMPLOYERS UABIl1TY 1NSURANCE
, s7. Paul f��r� 55102 POUCY
CARR i ER COD"c 13706 � ����.�7�L
INFORMATION PAGE- RENEWAL
-_ - �_.
POUCY NUMBER from POUCY PEi�lOU to PREV. COVERAGE: AGENCY P '.'.A/C Mb
wvo 6302411-86 o4/2gI85 04/29/86 767�E2652 Z2o5766 00 04/8$ .
� NAMED INSURED AND ADQRESS � > : '':AGENT ;,:; �
ITEM ST. PAllL URBAN i NO I AN W A LANG .CO �
'!. HEALTH BOARD CLINIC �
301 FULLER AVENUE 9TH E CEDAR ST
ST. PAUL. MN 55103 ST PAUL MN §5101
• INSURED IS — CHARITABLE ORGANIZATION , ,
OTHER WORKPLACES NOT SHOWN ABOVE: NO ADDITIONAI. LOCATIONS
� ITEM 2. POLICY PERI00: FROM 04/29/85 TO 04/29/86
12:01 AM STANOARD TIME AT THE INSUREO'S MAlLiN6 ADDRESS.
(TEM 3. A. WORKERS COMPENSATION INSURANCE: PART ONE OF THE POLICY APPLIES TO
THE WORKERS COMPENSATION LAW OF THE STATES LISTED HERE:
MN. '
8. EMP�OYERS LIABILITY INSURANCE: PART TWQ OF TNE POLICY APPLtES TO WORK
tN EACH STATE LISTED 1N ITEl1 3.A. THE LIMlTS OF OUR LIABILITY UNDER
PART TWO ARE: BODILY INJURY 8Y ACCIDENT S100,000 EAGH ACCIDENT
BODILY INJURY BY DISEASE $50Q,000 POLICY LIMIT
BODILY INJURY BY DISEASE $100,000 EACH EMPLOYEE
"' C. OTHER STATES INSURANCE: PART THREE OF THE POLICY APPLIES l'0 THE STATE ��
LISTED HERE: ALL STATES EXCEPT THOSE DESIGNA7ED lN ITEM 3.A ABOVE. ANO
NV.ND.OH,WA,WV�WY. •
_ _ _ _ _D_ NU�MBERS OF_ENDORSEMENTS FORMING A PART_OF THIS_POLICY _ NONE_ _ _ `
17EM 4. TNE PREMIUM FOR THIS POLICY WILL BE DETERMINED BY OUR MANUALS OF RULES.
CLASSIFICATIONS. RATES, AND RATING PLANS. ALL INFORMATlON REQUIRED BELOW �
(S SUBJECT TO VERIFlCATION ANO CHANGE BY AUDIT.
AOJUSTMENT OF PREMIUM SHALL 6E MADE UPON POLICY EXPIRATlON. � �
CLASSIFICATION OF OPERATIONS PRM—BASIS RATE EST �
ST LOC CODE TYP TOT—EST PER $100 ANNUAL
NO RSK ANN—REMUN REMUN PREMIUM
SEE ATTACHED SCHEDULE 308
MINIMUM PREMIUM 5250 EXPENSE CONSTANT �p .
' . TOTAL ESTIMATED ANNUAL PREMIUFI 5318
. � DEPOSIT PREMIUM S31$
/ , -
COUNTER51 GNcD TH I 5 DAY OF , �g _ _ _ '_= �_ _ L'�� _ _
AUTHORlZED REPRESENTATIVE
��
�:;C OQ 00 O1 . ,
_ ISSUE �ATE 04/Ib/85
�.�• .�. . • . . -� 1:: �.5 -. CJTYA:fiN; :73s NATlONAL COiINCI: �tJ Ca�tPf!l5.47!(r%i lyy./,..�;.�l.
-'80� .»
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- ;�="���' �'�� 1 MSUREO COPY '1- SB ',�v� 6 02411-8b �
� ... _ �,� • . , .
ST �AUL Fii�= rND NIARINE !NS CO WQRKERS COMPfNSATIQN ANO
. + 385 WASHING70N ST. EMPL�YERS llABillTY lNSURANCE
ST. PAUL MN 55102 PQLICY
��'��-/7Dt`
,,�` INFORMATtON PA6E— RENEWAL
V
POUGY NUMBER trom POLICY PERIOQ to PREV. COVERAGE AGENCY ? A!C MO
wvo 63o24t1-86 04/29/85 o4/Z9/86 767�E265Z 2205766 00 04%85
; ,.: .;.; NAMED INSURED ANa ADORESS <;:,� ';. :: ;::' �;AGENT '::. ;�:
l7EM ST. PAUL URBAN INOfAN � W A LANG CO :
1. HEALTH BOARD CL1NlC �
,
301 FULLER AVENUE 9TH b GEDAR ST
ST. PAUL, MN 55103 ST PAUL MN 551ot
POLICY �� 5 C H E D U L E 0 F 0 P�E�R A T I 0 N 5 *�� SCHEDULE
PAGE 2 � PAGE 1
ITEM 4. CLASSIFICATION OF OPERATIONS PRM-BASIS RATE EST
ST LOC CODE TYP TOT-EST PER $100 ANNUAL
NO RSK ANN-REMUN REMUN PREMIUM
� MN 001 8832 PHYSICtAN b CLERICAL 54.000 .S] $308
SUB-TOTAL 308
70TAL EST STANOARD PRE111UM FOR MINNESOTA S308
(ti T. . -
�:;c nn o0 oi iss�!� ^,��E �':!�5/8
�:�. ..... �•�,: ... .':7 Sfi 1i.5.�'*. CJPYR:G+1� '9EL�y:.:';/a,•:qL COt�iCl: dr'11 CO�l.Ps'�.;StON INSUpANCE,
�81� .
}
Cou�unit�S�,':�ices p�PARTMENT � � �-��--/70�- NO 3114
Col�een Gearv Carter CONTACT
292-7724 PHONE
, November 18, 1985 DATE �Q,/�� �Qr
ASSIGN NUMBER FOR ROUTING ORDER Cli All Locations for Si nature :
.X6e artment Director Director of Management/Mayor
inance and Management Services Director City Clerk
�Cudget Director � Ci� Couh�� l
ity Attorney
WHAT WILL BE ACHIEVED BY TAKING ACTION ON THE ATTACHED MATERIALS? (Purpose/
Rationale) :
Resolution authorizing a contract between the City of Saint Paul through
its Division of Public Health and Ramsey County whereby the City and County
provide funcling to Urban �ndian Health Clinic. RECE11/ED
NOV 2 5 #�°��.�;
COST/BENEFIT, BUDGETARY AND PERSONNEL IMPACTS ANTICIPATED: CITY ATTO�NEY
The City contr�,but�on to Urban Ind�an Health Clinic 3.s $27,562.
No personnel impacts are anticipated.
FINANCING SOURCE AND BUDGET ACTIVITY NUMBER CHARGED OR CREDITED: (Mayor's signa-
ture not re-
Total Amount of Transaction: $27,5 6 2. quired if under
$10,00Q)
Funding Source:
Activity Number: 03232
ATTACHMENTS (List and Number All Attachments) :
1. Photocopy of contract R�C�j��L7
2. Insurance Certificate N�V 2 61985
3. Resolution MAYpRS�FF�Cf
..
DEP TMENT REVIEW CITY ATTORNEY REVIEW /
es No Council Resolution Required? Resolution Required? ��s No
�es No Insurance Required? Insurance Sufficient? Yes No -
es No Insurance Attached:
(SEE REVERSE SIDE FOR INSTRUCTIONS)
R d 12/84 �
i
HOW TO USE THE GREEN SHEET
• ,,� � • ,
The GREEN SHEET has several PURPOSES:
1, to assist in routinq documents and in securing required signatures
2. to brief the reviewers of documents on the impacts of appz'oval
3. to help ensure that necessary supporting materials are prepared, and, if
required, attached.
Providing complete information under the listed headings enables reviewers to make
decisions on the documents and eliminates follow-up contacts that may delay execution.
The COST/BENEFIT, BUDGETARY AND PERSONNEL IMPACTS heading provides space to explain
the cost/benefit aspects of the decision. Costs and benefits related both to City
budget (General Fund and/or Special Funds) and to broader financial impacts (cost
to users, homeowners or other groups affected by the action) . The personnel impact
is a description of change or shift of Full-Time Equivalent (FTE) positions.
If a CONTRACT amount is less than $10,000, the Mayor's signature is not required,
if the department director signs. A contract must always be first signed by the
outside agency before routing through City offices.
Below is the �referred ROUTING for the five most frequent types of documents:
CONTRACTS (assumes authorized budget exists)
� 1. Outside Agency 4. Mayor
2. Initiating Department 5. Finance Director
3. City Attorney 6. Finance Accounting
ADMINISTRATIVE ORDER (Budget Revision) _ ADMINISTRATIVE ORDERS (all others)
l. Activity Manager 1. Initiating Department
2. Department Accountant 2. Ci�y Attorney
3. Department Director 3. Director of Management/Mayor
4. Budget Director 4. City Clerk
5. City Clerk
6. Chief Accountant, F&MS
COUNCIL RESOLUTION (Amend. Bdgts./Accept. Grants) COUNCIL RESOLUTION (all others)
1. Department Director • 1. Initiating Department
2. Budget Director 2. City Attorney
3. City Attorney 3. Director of Management/Mayor
4. Director of Management/Mayor 4. City Clerk
5. Chair, Finance, Mngmt. & Personnel Com. 5. City Council
6. City Clerk
7. City Council
8. Chief Accountant, F&MS
SUPPORTING MATERIALS. In the ATTACHI�NTS section, identify all attachments. If the
Green Sheet is well done, no letter of transmittal need be included (unless signing •
such a letter is one of the requested actions) .
Note: If an agreement requires evidence of insurance/co-insurance, a Certificate of
Insurance should be one of the attachments at ti.me of routing.
Note: Actions which require City Council Resolutions include:
l. Contractual relationship with another governmental unit.
2. Collective bargaining contracts.
3. Purchase, sale or lease of land.
4. Issuance of bonds by City.
5. Eminent domain.
6. Assumption of liability by City, or granting by City of indemnification.
7. Agreements with State or Federal Government under which they are providing
funding.
8. Budget amendments.
���
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.,�., �. �t CITY OF S�,.INT PAUL
�' 01�"``''' { OFFZCE OF TAE CITY COD'YCIL
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COn�rlltt�e Report
F i�an��. Mana�ement� & Personnel �ammittee.
1. Approval of minutes from meeting held December 12, I985. �P�'R�U'�.�
2. Resolution es�ablishin� policy that aIl City-owned vehicles, except Lhose required to
be taken home, are used for business purposes only. (Finance Dept.) (Laid over from
12/17./85) k���2S�- -Fo,. w�`4u.3�.c�,�c�_ - �4P PKo V E,p � w��i�2f�*-v
3. Resolution �estab�Iishirr� polic.y that all City-owned vehicles cannot b; �e�d���o�r �p�ers�o�ne�'-�
purposes. (F,inance Dept.) (Laid over from 12/12/85) -<�£-C�v�ST � Fo�, u�ir���,
4. Resolution authorizing the financing and construction of the public parking ra� on
Bloc.k L in connection with the KTCa devel.opment. (PED) �� av� � wK• _"`���s
5. Ordinance amending Section 38.06 of the Administrative Code pertain�o � the
conversion of sick leave credits to vacation leave. (Personne_) i�°
6. Resolution amending the 1985 bud;et by adding $5,070 to the Financin; and Spending Plan
for the Dept. of Public Works. (Public Works) R'PP/�pU�'•
7. Resolution amending the 1985 budget by adding. $32,000 to the Financing and Spendin� Plan
for Special Projects-General Govt.-Promoting St. Paul. (Exec. Administration) �PP�v��_
8. Resolution amending the 1985 budget by adding $49,400 to the Financing and Spending Plan
for Traffic Signal F� Lighting Maintenance. (Public Works) �PRDU�
9. Resolution amending the I985 budget by transferring $49 400 frnm Contingent Reserve to�-
Traffic Operations and Maintenance. (Public Worics) �►°�R���
10. Resolution amending the I985 bud;et by transferring $47,564 from Contingent Reserve to
Exezrot Property Assessments (Street Maintenance Assessments-$46,846) and other
Assessments ($718.00). (General Govt.) G1'PPRO►��.
11. Resolution authorizing approval to issuance of �6,000,000 Port Authority Revenue Bonds
relatina to Eneray Park Land r�cquisition F Development Costs. (Port Authority)8����f0.
12. Resolution approvin; a Subordination Agreement of Iand use restriction in favor of �LLS��
City in Ordway Theatr� site to the loan and security doc Rpv� of a Port Authority
Ordway Theatre refunding bond issue. (City Attorney) 1°�'P
13. Resolution authorizing an agresment with Midway Chevrolet for lease of unmarked
�ehicles. (Police Dept.) �1PPRbu�n �
14. Resolution authorizing an agreement with �II�I. Dept. of Transportation for traffic contro�
sib al at LV. 7th Street and Trimk Hwy. 149. (Public �+lorks-Traffic) 1�\PPk�3�1�9
15. ; Res���ti��.�"��z�n an a eme�tt.�th the Courtty of Ra�nsey and �h�e St.-Paui Urban
. . � �
Indian I�ealth CZinic whereby the City aad Ct�mty provide funding to tlte �?,�.nic.in the
''amouttt o£ $Z7,5b2. (Conanunity Servi.ces) �QPRt��£O
CITY HALL SEVENTH FLOOR SAINT PAUL,MINNESOTA 5520�
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