HomeMy WebLinkAboutbocc.con.177.2008CLERK'S CHECK LIST
FOR CONTRACTS SUBMITTED TO CLERK AND RECORDER FOR SCANNING/ARCHIVING
CONTRACT #: J ~' J_Z~0 g
ORIGINATING DEPARTMENT/DIVISION: Nl~'Yl R.'rt .SfiLt-'! 6P/J
CONTACT PERSON: ~ i'~'1 1-~17c~~rhroNE #: y2~_ 2ad 3 .
PROJECT NAME: ~~~ ~~ /
^ BOCC AGENDA ITEM [-'1STAFF AUTHORIZED SIGNATURE
(Requires BOCC Signature) (per Revised Procurement Code 7/2005)
^ Over $50,000 (Requires County Manager's Signature)
/ CHECK PROCUREMENT TYPE:
^None ^Informal ^Formal ^Sole Source ^Emergency ^State Bid ^
^Compliance with House Bills 06-1343 and 07-1073 -Immigration Form (Under $10,000, Letters of Engagement, etc
®DOLLAR AMOUNT: BUDGET LINE ITEM/LEDGER NUMBER:
/ CHECK CONTRACT TYPE:
(for county employees)
ental Agreement (Requires BOCC Action)
,, Equipment; Supplies ^Grant Ageements (Requires BOCC Action)
(e.g. revenue) ^Change Order/Contract Amendment
CONTRACTOR: COMPLE'CE LEGAL OF NAME OF BUSINESS (if different from contractor)
Contract Execution Date: '~ ~'0$' ContraM End Date: G - 3 0 - D S
Automatic Renewal: ^Yes ^No Term of Contract:
~T~ All Contracts should be proofed for the following:
/ ^No Pages Missing
/ ^If a Page is Left Intentionally Blank -Note on Page
/ ^page numbered consecutively
/ ^All Signatures Affixed
/ ^All Dates Filled In
/ ^All Other Blanks Filled In
/ ^All Exhibits Attached p
/ ^HB 06-1343 and 07-1073 (Immigration Legislation) Included in RFP and/or Contract Q 15
/ ^All Legal Descriptions Attached (if applicable) ~ \ ,A~
/ ^Notice of Awazd/Notice to Proceed Attached (if applicable) ~(°s(T`
/ ^Warranty (if applicable)
/ ^Special Instructions for Finance Department:
/ ^Sent to Clerk and Recorder for Scanning/Archiving
/ ^Authorized Staff Person's Name:
BY CHECKING ABOVE AND ENTERING NAME, THE AUTHORIZED STAFF PERSON INDICATES THAT
THE ATTACHED DOCUMENT HAS BEEN PROOFED AND READY FOR SCANNING.
NOTE: CLERK'S OFFICE WILL KEEP ORIGINAL DOCUMENTS IN COMPLIANCE WITH COLORADO STATE
ARCHNES RETAINAGE SCHEDULE.
AMENDED 04/23/08
Rev 03/OS/08js
LETTER OF ENGAGEMENT
April 1, 2008
Project Name: Foster Caze Recruitment. Certification, Retention
Business Name: Wynne Morean, MSW
Address : P.O Box 555 or 227 Capital Street
City, State Zip Code Eaele, CO 81631
Re: Contract services for Foster Care Consultation
The purpose of this letter is to summarize the pertinent terms of Pitkin County's arrangement
with you to provide the specified services enumerated in the following paragraph. The
County's obligation under the Workers' Compensation Statute requires Pitkin County and
you to formalize the terms of this engagement in a notarized writing.
1. Term. The term of this contract is from April 1, 2008 through June 30, 2008.
2. Contractor's Obligations.
/ Consultation for Child Welfare Staff (ongoing and emergency)
/ Recertification /Updated Certification for present foster care parents
/ Certification for new foster care parents
/ Review old files, Update files and forms
/ Training for PCDHS staff (Emergency Placements, Kinship Placements, Long term
placements)
/ Reports and TRAILS entry
/ Any follow-up required as necessary and agreed upon between PCDHS staff and
contractor
3. Compensation and Expense, Invoicing, Payment and Offset. The county shall compensate ,
contractor for its services in accordance with the Project budget and Schedule set out in Pazagraph 1 -
2. It is expressly understood and agreed that in no event will the total compensation and
reimbursement to be paid hereunder exceed the sum of $5000.00 for all services rendered. Contractor
shall invoice for the project monthly based on hours worked at $50.00/hour with payment expected
within thirty (30) days of invoice, but any payment by the County may be offset by any amount the
Contractor owes the County for any reason. Payment of 50.00/hour includes travel and expenses.
It is mutually agreed that the County does not have an exclusive right to your services and it
is contemplated that you may provide similaz work to other businesses, governments and
non-profit organizations. You acknowledge that the work performed for Pitkin County will
be that of an independent contractor and that no employee-employer relationship is created.
You have full control over how the services are performed and it is expected that work will
be conducted in accordance with industry standazds by applying professional judgment. The
County will provide, if necessary, documents and information to complete the work
described in the preceding paragraph. The County representative signing this letter is
available to you to discuss any details related to this engagement. This letter of engagement
Rev 03/OS/08js
will terminate on December 31St and will require a new document in succeeding years to be
effective. You acknowledge and agree that you shall not be entitled to workers'
compensation benefits in connection with this project and that you shall be responsible
for the payment of all state and federal income taxes.
Compliance with House Bill 06-1343 and House Bi1107-1073
A. In compliance with House Bi1106-1343 and House Bi1107-1073 amending
Title 8 of the Colorado Revised Statutes by the addition of Article 17.5, Illegal Aliens-Public
Contract for Services, enacted by the General Assembly of the State of Colorado, the
Contractor shall not:
Knowingly employ or contract with an illegal alien to perform work
under this contract or;
2. Enter into a contract with a subcontractor that fails to certify to the
Contractor that the subcontractor shall not knowingly employ or
contract with an illegal alien to perform work under this contract.
B. In compliance with House Bi1106-1343 and House Bi1107-1073 enacted by the
General Assembly of the State of Colorado:
1. The Contractor has confirmed or attempted to confirm the employment
eligibility of all employees who are newly hired for employment in the United States
through participation in the Basic Pilot Program [created in Public Law 208, 104th
Congress, or its successor and expanded in Public Law 156, 108a' Congress, or its
successor, that is administered by the United States Department of Homeland
Security] and, if the Contractor is not accepted into the Basic Pilot Program prior to
entering into this contract, the Contractor shall apply to participate in the Basic Pilot
Program every three months until the Contractor is accepted or this contract has been
completed, whichever is eazlier. This provision shall not be required or effective if
the Basic Pilot Program is discontinued.
2. The Contractor shall be prohibited from using Basic Pilot Program
procedures to undertake pre-employment screening of job applicants while this
contract is being performed.
3. If the Contractor obtains actual knowledge that a subcontractor
performing work under this contract knowingly employs or contracts with an illegal
alien, the Contractor shall be required to:
a. Notify the subcontractor and the County within three days that
the Contractor has actual knowledge that the subcontractor is employing or
contracting with an illegal alien; and
b. Terminate the subcontract with the subcontractor if within
three. days of receiving the notice required pursuant to subparagraph (a) of this
pazagraph (3) the subcontractor does not stop employing or contracting with
the illegal aliens; except that the Contractor shall not terminate the contract
with the subcontractor if during such three days the subcontractor provides
2
Rev 03/OS/08js
information to establish that the subcontractor has not knowingly employed or
contracted with an illegal alien.
4. The Contractor shall comply with any reasonable request by the Department
of Labor and Employment made in the course of an investigation that the Department of
Labor and Employment is undertaking pursuant to the authority established in Subsection
(5) of C.R.S. § 8-17.5-102.
In all other respects the Agreement is in full force and effect and remains unchanged
by this Amendment.
If you aze in agreement with the terms of this letter, please sign below in the presence of a
notary and return a copy to us for our files. We appreciate the opportunity of working with
you.
' cerely,
r
itle of ounty Representative
STATE OF COLORADO
ss.
COUNTY OF PITKIN ) J
The forgoing instrument was acknowledged before m/e this% ~~Lday of Month, Year, by
Name of County Representative. ~in+ ~~/~! /,f~/ka~
Witnessed my hand and official seal.
My commission expires:
STATE OF COLORADO )
ss.
COUNTY OF-P~i1P ~AI~~-}
The forgoing instrument was acknowledged before me this
Name of Other Partys Name to Agreement. ~~~~ ,~
Witnessed my hand and official seal.
My commission expires:
Notary Public
~ J"une 2cng
day of Month, Year, by
.0,9%,
~..••' ca
~ o .~`
,~. o /day
3
Under lOK HB#
Compliance with House Bill 06-1343 and House Bi1107-1073
A. In compliance with House Bill 06-1343 and House Bill 07-1073 amending Title 8 of the Colorado Revised
Statutes by the addition of Article 17.5, Illegal Aliens-Public Contract for Services, enacted by the General
Assembly of the State of Colorado, the Contractor shall not:
Knowingly employ or contract with an illegal alien to perform work under this contract or;
2. Enter into a contract with a subcontractor that fails to certify to the Contractor that the
subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this contract.
B. In compliance with House Bi1106-1343 and House Bill 07-1073 enacted by the General Assembly of the State
of Colorado:
1. The Contractor has confirmed or attempted to confine the employment eligibility of all employees
who aze newly hired for employment in the United States through participation in the Basic Pilot Program [created
in Public Law 208, 104th Congress, or its successor and expanded in Public Law 156, 108'" Congress, or its
successor, that is administered by the United States Department of Homeland Security] and, if the Contractor is not
accepted into the Basic Pilot Program prior to entering into this contract, the Contractor shall apply to participate in
the Basic Pilot Program every three months until the Contractor is accepted or this contract has been completed,
whichever is eazlier. This provision shall not be required or effective if the Basic Pilot Progam is discontinued.
2. The Contractor shall be prohibited from using Basic Pilot Program procedures to undertake pre-
employment screening of job applicants while this contract is being performed.
3. If the Contractor obtains actual knowledge that a subcontractor perfomung work under this contract
knowingly employs or contracts with an illegal alien, the Contractor shall be required to:
a. Notify the subcontractor and the County within three days that the Contractor has
actual knowledge that the subcontractor is employing or contracting with an illegal alien;
and
b. Terminate the subcontract with the subcontractor if within three days of receiving
the notice required pursuant to subpazagraph (a) of this pazagraph (3) the subcontractor
does not stop employing or contracting with the illegal aliens; except that the Contractor
shall not terminate the contract with the subcontractor if during such three days the
subcontractor provides information to establish that the subcontractor has not knowingly
employed or contracted with an illegal alien.
4. The Contractor shall comply with any reasonable request by the Department of Labor and Employment
made in the course of an investigation that the Department of Labor and Employment is undertaking pursuant to the
authority established in Subsection (5) of C.R.S. § 8-17.5--102,. ""
Signed and dated this ~~ day of ,l fvr t~ . 20 O~ '
CONTRACTOR: PITKIN COUNTY:
By By -
AA MM Authorized Signer
Tile: '~ ~AAL, i'~~~ Department ~~1.Urtn - ~ ~/~~
Company Name : ~I"t f~l ~ l~lrl(~ ~y(olease print) `,
'l
aoe oiiw;ns ~,
~~
name) represent that (corporation name) has no person or persons
in its employ and that each stockholder of corporation
name) owns at least 10% of
's (corporation
name) stock, but that (corporation name) shall obtain
and maintain workers' compensation protection pursuant to those insurance
requirements as set forth in the Workers' Compensation Act of Colorado (Articles
40 to 54 of Title 8 of the Colorado Revised Statutes) for any and all persons as it
may employ in performing any work in the future.
(Corporation name) shall also require any
subcontractor it may contract with or obtain for any work to maintain workers'
compensation protection for its employees.
~ ~ ~~
Date si ed
n
~/2~7
Signature of Con ractor
, Pitkin County Risk Management
Workers' Compensation Waiver
~.rV ~ 2
I, n/r.~ in~ny capacity as ~ ~ title) of (corporation