HomeMy WebLinkAboutbocc.con.amended.071.2010ACLERK'S CHECK LIST
FOR CONTRACTS SUBMITTED TO CLERK AND RECORDER FOR
SCANNING/ARCHIVING
coNTxacT #: o��_2� � �� ���
Originating DeparhnenUDivision: Health & Human Se es
Contact Person: Mitzi Ledingham Phone #: 920-5766
Project Name: Healthy Community Fund Grant Programs
❑ BOCC AGENDA ITEM �STAFF AUTHORIZED SIGNATURE
(BOCC signamre required) (per Revised Procurement Code 7/2005)
Check procurement type:
�None �Informal �Formal �Sole Source ❑Emergency QState Bid ❑
Check Contract Tvue:
Dollar Amount: $20,000
Budget Line Item/Ledger Number 113.85.00000.84030
(for county employees)
ental Agreement (Requires BOCC Action)
�, Equipment, Supplies
{e.g. revenue)
Agreements (Requires BOCC Action)
;e Order/Contract Amendment
Contractor/Business Complete Legal Name: Hospice ofthe Valley
Contract Execution 1/3/2011 Contract End Date: 12/31/11
Automatic Ren�wal Term of Contract: annual; automatic 12
month extensionl
All Contracts should be proofed far the following:
❑No Pages Missing
�If a Page is Left Intentionally Blank —Note on Page
�Page numbered consecutively
Signatures Affixed
Dates Filled In
Other Blanks Filled In
Exhibits Attached
� ��
UAIl Legal Descriptions Attached ��fapProPdace�
❑Notice of Award/Proceed Attached �tr approP,;ace)
�Special Instrnctions for Finance Department: see grant payment worksheet
�Sent to Clerk and Recorder for Scanning/Archiving
�Authorized Staff Person's Name: Mitzi Ledingham
❑Warranty,ifapplicable .
BY CHECHING ABOVE AND ENTERING NAME, THE AUTHORIZED STAFF
PERSON INDICATES THAT DOCUMENT HAS BEEN PROOFED AND READY
FOR SCANNING.
Note: Clerk's Office will keep origina7 documents in compliance with Colorado State
Archives retainage schedule.
Contract # 071-2010-A
� .�
Change Order Number: 1
OWNER: Pitkin County HHS
c/o Mitzi Ledingham
0405 Castle Creek Rd. suite 7
Aspen, CO 81611
CONTRACTOR:
Hospice ofthe Valley
P.O. Box 3768
Basalt, CO 81621
c/o ED Markey Butler
Rev 12/10/09�s
The 2010 Hospice of the Valley annual grant agreement (the "AgreemenY') dated Januarv lst, 2010
between the Board of County Commissioners of Pitkin County (the "County") and Hospice of the Valley
(the "Contractor"), is hereby amended as follows:
Descrintion of Chanee: continuation of contract terms for 2011 with funding at $30,000
Reason for Chanee: additional 12 month extension of 2010 Agreement
Original Contract Price
Net Increase/Decrease in Contract Price (this change order)
Total Adjusted Contract Price (including this change order)
$ 20.000
$ + 10.000
$ 30.000
In all other respects the Agreement is in fiill force and effect an3 remains unchanged by this
Amendment.
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C�tractor �
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Authorized Count� Representative
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Date
z-�-11
Date
1
CHANGE ORDER/CONTRACT AMENDMENT