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Home My WebLink Aboutbocc.con.216.2010 CLERK'S CHECK LIST FOR CONTRACTS SUBMITTED TO CLERK AND RECORDER FOR SCANNING /ARCHIVING CONTRACT #: 0, l (' - a o) Q ORIGINATING DEPARTMEN / DIVISION: pc 0 S CONTACT PERSON: 1�� \ Hi id t Xb HONE #: I fp i a04 3 PROJECT NAME: Cit,u. Illy . ❑ BOCC AGENDA ITEM STAFF 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 ES Source ❑Emergency ['State Bid ❑ Compliance with House Bills 06 -1343 and 07 -1073 — Immigration Form (Under $10,000, Letters of Engagement, e DOLLAR AMOUNT: 51200 , 0 D BUDGET LINE ITEM/LEDGER NUMBER: g r o? t ; 1/ 7, / 3 If CHECK CONTRACT TYPE: CIA ,u_ We, "S ervices/Maintenance ['Employment (for county employees) ❑License/Use ❑Intergovernmental Agreement (Requires BOCC Action) DLease ❑Non- Profit ❑Construction ❑Quasi - Public ❑Goods, Equipment, Supplies ❑Grant Agreements (Requires BOCC Action) ❑Other (e.g. revenue) ❑Change Order /Contract Amendment CONTRACTOR: COMPLETE LEGAL OF NAME OF BUSINESS (if different from contractor) Contract Execution Date: (Di/Ad/0 Contract End Date: /° Automatic Renewal: [Yes ❑No Term of Contract: a- rwvs, Ce -_6 am All Contracts hould be proofed for the following: , ✓ ` No Pages Missing 1 ✓- ErIf a Page is Left Intentionally Blank —Note on Page ✓ [✓ TPage numbered consecutively ✓ [A11 Signatures Affixed ✓ [� Dates Filled In , ( 11 Other Blanks Filled In s 11 Exhibits Attached ✓ [CHB 06 -1343 and 07 -1073 (Immigration Legislation) Included in RFP and/or Contract ✓ ❑All Legal Descriptions Attached (if applicable) ✓ ❑Notice of Award/Notice to Proceed Attached (if applicable) ✓ ❑Warranty (if applicable) ✓ DSpecial Instructions for Finance Department: ✓ ZSent to Clerk and Recorder for Scanning/Archiving ✓ ZAuthorized 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 ARCHIVES RETAINAGE SCHEDULE. AMENDED 04/23/08 LETTER OF ENGAGEMENT Contract#216-2010 October 1,2010 Project Name: Caze Manaeement Services ConlractoriBusiness: Sole Name: Saza Montae Address : 80 Aspen Village Ciry, State, Zip Code: Aspen, CO 81611 Re: Care Management Servlces 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 pazagraph. The Counry's obligation under the Workers' Compensation Statute requires Pitkin Counry and you to formalize the tertns of this engagement in a notarized writing. Term. The term of this contract is from September 1, 2010 through December 31, 2010. Scope of Services: Assessment and Service Coordination tor Care Management Clients (Clients over the age ot 60 who qualify for such services determined by Youth, Family and Adult Services Manager) ✓ Documentation ot client contacts, monitoring reports and other apprupriate reports as identified by Youth, Family and Adult Services Manager. ✓ Regular verbal and written communication regarding client status as appropriate with PCDHS Sta[f ✓ Any follow-up required as necessary and agreed upon between PCDHS staff and contractor The county shall compensate wntractor 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 ro be paid hereunder exceed the sum of $5000.00 for all services rendered. Con�actor shall invoice for the project monthty based on hows worked at $25.00/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 25.00/hour includes uavel 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 similar work ro other businesses, govemmenu 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 convol over how the services aze performed and it is expected that work will be conducted in accordance with industry standazds by applying professional judgment. The County wil] provide, if necessary, documenu and information to complete the work described in the preceding pazagraph. The Counry representative signing this letter is available to you to discuss any details related to this engagement. This letter of engagement will terminate on December 31s`, 2010 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 t6is project and that you shall be responsible for the payment of all state and federal income taxes. Rev 03/OS/OSjs s e s Rev 03/OS/08js Comnliance with House Bill Ob-1343 and Aouse Bi1107-] 073 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 foc Services, enacted by the Genenl 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 subconhactor that fails ro certify to the Contractor that the subcontractor shall not lmowingly employ or contract with an illegal alien ro perform work under this contract. B. In compliance with Aouse Bill 06-1343 and House Bill 07-] 073 enacted by the General Assembly of the State of Colorado: 1. The Contractor has confumed or attempted ro conSrm 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 Departrnent of Homeland Securiry] and, if the Contractor is not accepted into the Basic Pilot Program prior to entering into this conuact, the Contractor shall apply to participate in the Basic Pilot Program every three months until the Conhactor is accepted or this contract has been completed, whichever is earlier. This provision shall not be requ'ved 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 ofjob applicants while this conhact is being performed. 3. If the Contractor obtains actual knowledge that a subconffactor performing work under this contract Irnowingly employs or contracu with an illegal alien, the Conuactor shall be required to: a. Notify the subconuactor and the Counry within three days that the Contractor has actual knowledge that the subconlsactor is employing or contracting with an illegal alien; and b. Tertninate the subcontract with the subconffactor if within tivee 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 Conuactor 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 Depardnent of Labor and Employment made in the course of an investigation that the Department of Labor and Employment is undertaking pursuant to the authoriry 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 are in agreement with [he terms of this letter, please sign below in the presence of a notary and retum a copy to us for our f les. We appreciate the ortunity of working with you. t rely, ` Tit e of C nty Represen ti3e STATE OF COLORADO ) ) ss. COUNTY OF PITKIN ) ..... Rev 03/OS/08js � ��e� , 7.0 ►a The forgoing instrument was acknowledged before me this �, day c�€-A4ewtlk i�', by S'�.�.--m�� , Witnessed my hand and official seal. My commission expires: � � ( (�� `�� -L�-6fi�t Notary Public AGREF�D: /G�� -� Other Party's Name to A eement STATE OF COLORADO COUNTY OF PITKIN ) ) ss. ) ,� '�. &"��, ZuIU The forgoing instrument was aclrnowledged before me this �? day of A4onti�, 3 fe�; by ° � rn °�°� � Witnessed my hand and official seal. My commission expires:��.��Vl�{K.��N ��vi� �� -1��- / � /(�`_t-��,�( L� Notary Public � � � Under lOK HB# Comnliance with House Bill 06-1343 and House Bi1107-1073. A. In compliance with House Bill 06-1343 and House Bill 07-] 073 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 conhact with an illegal alien to perform work under this contract. B. In compliance with House Bill 06-1343 and House Bi1107-] 073 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, 108�' Congress, or its successar, 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 wntract, the Contractor shall apply to par[icipate in the Basic Pilot Program every three mont6s until the Contractor is accepted or this contract has been completed, whichever is earlier. 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 subpazagraph (a) of this paragraph (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 Departrnent of Labor and Employment is undertaking pursuant to ihe authority established in Subsection (5) of C.R.S. § 8-17.5-102. Signed and dated this �� day of CONTRACTOR: B �.��,�. Title: L�c92� �G�PL -� .20 IO PITKIN COUNTY: By;�� Authorized 3igner Deparknent: �� Company Name : (olease arinU �