HomeMy WebLinkAboutbocc.con.072.2011 Rev. 08 -30 -11 jls
111, COUNTY CLERK'S
CONTRACT COVERSHEET
CONTRACT #: 72 -2011
ORIGINATING DEPARTMENT: Airport
PROCUREMENT OFFICER: Jim Elwood PHONE #: 9704292581
PROJECT NAME: Executive Search CONTRACTOR: ADK Executive Search
DOLLAR AMOUNT: $16,500.00 LINE ITEM # 404.67.00000.82009
CONTRACT EXECUTION DATE: 12/9/2011 CONTRACT END DATE: 11/14/2012
AUTOMATIC RENEWAL: ❑ YES ® NO TERM: 12/9/2011- 11/14/2012
❑ BOCC AGENDA ITEM (Grants, IGA) ® STAFF AUTHORIZED SIGNATURE
(Requires BOCC Signature) (Per Revised Procurement Code 7/2005)
❑ OVER $50,000 (Requires Section Leader & County Manager's Signature)
✓ CHECK PROCUREMENT TYPE:
❑ None ® Informal ❑ Formal ❑ Sole Source ❑ Emergency ❑ Outside Agency /State Bid
❑ Compliance with C.R.S. 8 -17 -5 -101, 102 as amended (Immigration Form) ❑ Exempt
❑ Contract Renewal
✓ CHECK CONTRACT TYPE: ' A G t�
® Services/Maintenance ❑ Employment
❑ License/Use ❑ Intergovernmental Agreement (Resolution Required)
❑ Lease ❑ Non -Profit
❑ Construction ❑ Quasi - Public (e.g. -AVH)
❑ Goods, Equipment, Supplies ❑ Grant Agreements (Notify Finance & Resolution Required)
❑ Other (e.g. revenue) ❑ Change Order /Contract Amendment
(C /O: 10% or $25K whichever is the lesser must have County Manager signature)
All Contracts should be proofed and all exhibits and notices must be attached for the following:
✓ ® No Pages Missing ✓® All Other Blanks Filled In
✓ ❑ If Page Left Intentionally Blank — Note on Page ✓® All Exhibits Attached
✓ ® Page numbered consecutively ✓® All Legal Descriptions attached (f applicable)
✓ ® All Original Signatures Affixed ✓❑ Notice of Award/Notice to Proceed Attached (f applicable)
✓ ® All Dates Filled In ✓❑ Warranty (if applicable)
✓ ❑ Special Instructions for Finance Department:
✓ ® Authorized Procurement Officer's Name: Jim Elwood
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. ALL ATTACHMENTS MUST BE WITH THIS CHECKLIST!
Contract #72 -2011 Rev. 8.31.11 jaa /js
Budget Line Item# 404.67.00000.82009
K I
OUN
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CONTRACT FOR PROVISION OF SERVICES
Executive Search
THIS CONTRACT is made and entered by and between the Pitkin County Board of County
Commissioners ( "County") and ADK Executive Search (hereinafter "Contractor ").
1. Term. The term of this contract is from November 15 2011 to November 14 2012.
2. Contractor's Obligations. Contractor shall refer to attached Scope of Work.
3. Compensation and Expenses, Invoicing, Payment and Offset. The County shall compensate
Contractor for its services in accordance with the Project Budget and Schedule set out in Paragraph 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 $16,500.00 for all services rendered unless otherwise
mutually agreed upon by Contractor and County in writing. By contract or amendment, the County
and Contractor may reallocate the budget among project tasks if the total budget amount remains
unchanged. Contractor shall invoice for the project monthly based on hours worked, 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.
4. County's Exclusive Ownership of Work Product. Drawings, specifications, guidelines and
other documents prepared by Contractor in connection with this contract shall be the property of the
County. However, Contractor shall have the right to utilize such documents in the course of its
marketing, professional presentations, and for other business purposes. Contractor assigns to County
the copyrights to all work prepared, developed, or created pursuant to this contract, including the
right to: 1) reproduce the work; 2) prepare derivative works; 3) distribute copies to the public; 4)
perform the works publicly; and 5) to display the work publicly. Contractor shall have right to use
materials produced in the course of this contract for marketing purposes and professional
presentations, articles, speeches and other business purposes.
5. Pitkin County's Obligations. Pitkin County shall administer this contract through a County
Representative. Jim Elwood will manage the project as the County's Representative. In the event
that Jim Elwood is not available, Danette Logan shall assume the County Representative's duties.
The services provided and products delivered by the Contractor under this contract will be subject to
review by the County's Representatives, or a designee, for compliance with Contractor's obligations
prior to final payment.
6. Termination Prior to Expiration of Contract Term. The County has the right to terminate
this contract, with or without cause, by giving written notice to the Contractor of such termination
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and specifying the effective date thereof. Such notice shall be given at least ten (10) days before the
effective date of such termination. In such event all finished or unfinished documents, data, studies
and reports prepared by the Contractor pursuant to this contract shall become the County's property.
Contractor shall be entitled to receive compensation in accordance with the contract for any
satisfactory work completed pursuant to the terms of this contract prior to the date of termination.
Not the above, Contractor shall not be relieved of liability to the County for damages
sustained by the County by virtue of any breach of the contract by the Contractor.
7. Independent Contractor Status.
A. The parties to this contract intend that the relationship between them contemplated by
the contract is that of independent contractor. Contractor, and any agent, employee, or servant of
Contractor shall not be deemed to be an employee, agent, or servant of Pitkin County.
B. Contractor is not required to offer his services exclusively to Pitkin County under this
contract. Contractor may choose to work for other individuals or entities during the term of this
contract, provided that the basic services and deliverable products required under this contract are
submitted in the manner and on the schedule defined under this contract.
C. Contractor warrants that all work produced will conform to all applicable industry
standard of care, skill and diligence in the performance of Contractor's obligations under this
contract.
D. Contractor shall not attempt to oversee or supervise the work or actions of any Pitkin
County employee, servant or agent in the course of completing work under this contract.
E. Contractor is not entitled to any Workers' Compensation benefits through Pitkin
County and is responsible for payment of any federal, state, FICA and other income taxes.
8 Assignability. This contract is not assignable by either party. Any use of subcontractors by
the Contractor for performance of this contract must be accepted in writing by the County.
9. Binding Arbitration. Any disputes arising out of this contract shall be subject to binding
arbitration. The parties agree that any disputes concerning the terms and conditions of this contract
shall be submitted and fmally settled by arbitration. Arbitration shall be conducted pursuant to the
rules of the American Arbitration Association and shall be presided over by the Pitkin County
Hearing Officer appointed to arbitrate Pitkin County contract disputes. Costs of the arbitration shall
be awarded to the substantially prevailing party.
10. Severability. In the event that any provision of this contract shall be held to be invalid or
unenforceable, the remaining provisions of this contract shall remain valid and binding upon the
parties hereto
11. Integration and Modification.
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Budget Line Item# 404.67.00000.82009
A. This contract represents the entire and integrated contract between the County and the
Contractor and supersedes all prior negotiations, representations, or contract, either written or oral.
This contract may be amended only by written contract signed by both the County and the Contractor.
B. The County may, from time to time, request changes in the scope of services of the
Contractor to be performed hereunder. Such changes, including the increase or decrease in the
amount of the Contractor's compensation, which are mutually agreed upon between the County and
the Contractor, shall be in writing and upon execution shall become part of this contract.
12. Indemnity.
A. The Contractor agrees to indemnify, hold harmless and, not excluding the County's right
to participate, defend the County, its subsidiary, parent, associated and/or affiliated entities, successors,
or assigns, its elected officials, trustees, employees, agents, volunteers, and any jurisdiction or agency
issuing permits for any work included in the project„ hereinafter referred to as indemnitee, from all
suits and claims, including attorney's fees and cost of litigation, actions, loss, damage, expense, cost or
claims of any character or any nature arising out of the work done in fulfillment of the terms of this
Contract or on account of any act, claim or amount arising or recovered under workers' compensation
law or arising out of the failure of the Contractor to conform to any statutes, ordinances, regulation, law
or court decree. It is agreed that the Contractor will be responsible for primary loss investigation,
defense and judgment costs where this contract of indemnity applies. In consideration of the award of
this contract, the Contractor agrees to waive all rights of subrogation against the County its subsidiary,
parent, associated and/or affiliated entities, successors, or assigns, its elected officials, trustees,
employees, agents, and volunteers for losses arising from the work performed by the Contractor for the
County.
B. The Contractor further shall investigate, process, respond to, adjust, provide defense for
and defend, pay or settle all claims, demands, or lawsuits related hereto at its sole expense and shall
bear all other costs and expenses related thereto, even if the claim, demand or lawsuit is groundless,
false or fraudulent.
13. Insurance. Contractor and subcontractors shall procure and maintain until all of their
obligations have been discharged, including any warranty periods under this Contract are satisfied,
insurance against claims for injury to persons or damage to property which may arise from or in
connection with the performance of the work hereunder by the Contractor, its agents, representatives,
employees or subcontractors.
The insurance requirements herein are minimum requirements for this Contract and in no way limit
the indemnity covenants contained in this Contract.
The County in no way warrants that the minimum limits contained herein are sufficient to protect the
Contractor from liabilities that might arise out of the performance of the work under this Contract by
the Contractor, its agents, representatives, employees, or subcontractors. The Contractor shall assess
its own risks and if it deems appropriate and/or prudent, maintain higher limits and/or broader
coverages. The Contractor is not relieved of any liability or other obligations assumed or pursuant to
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the Contract by reason of its failure to obtain or maintain insurance in sufficient amounts, duration,
or types.
A. Coverage and Limits of Insurance. Contractor shall provide coverage with limits of
liability not less than those stated below. An umbrella and/or excess liability policy may be used to
meet the minimum liability requirements provided that the coverage is written on a "following form"
basis.
1. Statutory Workers' Compensation: Colorado statutory minimums
a. Policy shall contain a waiver of subrogation against the County.
b. This requirement shall not apply when a contractor or subcontractor
is exempt under Colorado Workers' Compensation Act., AND when such
contractor or subcontractor executes the appropriate waiver form.
Minimum Limits:
Coverage A (Workers' Compensation) Statutory
Coverage B (Employers Liability) $ 500,000
$ 500,000
$ 500,000
2. Commercial General Liability — ISO 1CG 0001 form or equivalent.
(With County named additional insured)
Minimum Limits:
General Aggregate $ 2,000,000
Products /Completed Operations Aggregate $ 2,000,000
Each Occurrence Limit $ 1,000,000
Personal/Advertising Injury $ 1,000,000
Fire Damage (Any One Fire) $ 50,000
Medical Payments (Any One Person) $ 5,000
Coverage to include:
• Premises and Operations
• Explosions, Collapse and Underground Hazards
• Personal / Advertising Injury
• Products / Completed Operations
• Liability assumed under an Insured Contract (including defense costs assumed under
contract)
• Independent Contractors
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• Designated Construction Projects(s) General Aggregate Limit, ISO CG 2503 (1997
Edition or equivalent)
• Additional Insured— Owners, Lessees or Contractors Endorsement, ISO Form 2010
(2004 Edition or equivalent)
• Additional Insured — Owners, Lessees or Contractors Endorsement, ISO CG 2037
(2004 Edition or equivalent)
• The policy shall be endorsed to include the following additional insured language on
the Additional Insured Endorsements specified above: "County, its subsidiary, parent,
associated and/or affiliated entities, successors, or assigns, its elected officials,
trustees, employees, agents, and volunteers named as an additional insured with
respect to liability and defense of suits arising out of the activities performed by, or on
behalf of the Contractor, including completed operations ".
3. Auto Liability: Bodily injury and property damage for any owned, hired, and
non -owned vehicles used in the performance of this Contract.
Minimum Limits:
Bodily Injury/Property Damage (Each Accident) $ 1,000,000
4. Special Coverages (check as appropriate and insert amount):
0(1) Performance Bond $
❑ Labor and Material $
❑ Payment Bond $
n (2) Professional Errors and Omissions
0(3) Aircraft Liability
0(4) Owner's Protective
0(5) Builder's Risk
❑(6) Boiler and Machinery
0(7) Loss of Use Insurance
0(8) Pollution Liability
n Crime, including Employee Dishonesty Coverage, or Fidelity Bond
B. Proof of Insurance:
1. Each insurance policy required by the insurance provisions of this Contract
shall provide the required coverage and shall not be suspended, voided or canceled except
after thirty (30) days prior written notice has been given to the County, except when
cancellation is for non - payment of premium, then ten (10) days prior notice may be given.
Such notice shall be sent directly to (County Representative's Name & Address). If the
insurance carrier will not provide the required notice, the Consultant/Contractor and or its
insurance broker shall notify the County of any cancellation, or reduction in coverage or
limits of any insurance within seven (7) days of receipt of insurers' notification to that effect.
Simultaneously with the Certificates of Insurance, the Contractor shall file with the
Procurement Officer a certified statement as to claims pending against the required coverages,
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reserves established on account of such claims, defense costs expended and amounts remaining
on policy limits.
2. In addition, these Certificates of Insurance shall contain the following clauses:
a. The contractor's insurance shall be primary and non - contributory with
any insurance or self insurance purchased by the County.
b. The insurance companies issuing the policy or policies hereunder shall
have no recourse against the County of Pitkin for payment of any premiums or for
assessments under any form of policy.
c. Any and all deductibles or self insured retentions in the above - described
insurance policies shall be assumed by and be for the amount of, and at the sole expense
of the Contractor.
d. Location of operations shall be: "all operations and locations at which
work for the referenced Project is being done."
3. Certificates of Insurance for all renewal policies shall be delivered to the
County's Representative at least fifteen (15) days prior to a policy's expiration date except for
any policy expiring on the expiration date of this contract or thereafter.
4. The County reserves the right to request and receive a copy of any policy and
any policy endorsement at any time during the term of this contract.
14. Exemptions and Preferences. All purchases of construction or building or any other materials
for this contract shall not include Federal Excise Taxes or Colorado State or local sales or use taxes.
Pitkin County is exempt from such taxes under registration numbers 98 -02624 and 84- 78000 -5K.
15. Records. The Contractor shall maintain comprehensive, complete and accurate books, records,
and documents concerning its performance relating to this contract for a period of three (3) years after
final payment under the contract and the County shall have the right within the three (3) year period to
inspect and audit these books, records and documents, upon demand, in a reasonable manner and at
reasonable times, for the purpose of determining, by accepted accounting and auditing standards,
compliance with all provisions of the contract and applicable law.
16. Contract Made in Colorado. The parties agree that this contract was made in accordance with
the laws of the State of Colorado and shall be so construed. Venue is agreed to be exclusively in the
courts of Pitkin County, Colorado.
17. Attorney's Fees. In the event that legal action is necessary to enforce any of the provisions of
this contract beyond the arbitration described in Paragraph 9, the substantially prevailing party shall be
entitled to its costs and reasonable attorney's fees.
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18. Governmental Immunity. Contractor agrees and understands that Pitkin County is relying on
and does not waive, by any provision of this contract, the monetary limitations or terms (presently
$150,000 per person and $600,000 per occurrence) or any other rights, immunities, and protections
provided by the Colorado Governmental Immunity Act, 24 -10 -101, et seq., C.R.S., as from time to
time amended, or otherwise available to Pitkin County or any of its officers, agents or employees.
Further, nothing in this contract shall be construed or interpreted to require or provide for
indemnification of the Contractor by the County for any injury to any person or any property damage
whatsoever which is caused by the negligence or other misconduct of the County or its agent or
employees.
19. Current Year Obligations. The parties acknowledge and agree that any payments provided
for hereunder or requirements for future appropriations shall constitute only currently budgeted
expenditures of Pitkin County. Pitkin County's obligations under this contract are subject to Pitkin
County's annual right to budget and appropriate the sums necessary to provide the services set forth
herein. No provisions of the contract shall constitute a mandatory charge or requirement in any
ensuing fiscal year beyond the then current fiscal year of Pitkin County. No provision of the contract
shall be construed or interpreted as creating a multiple -fiscal year direct or indirect debt or other
financial obligation of Pitkin County within the meaning of any constitutional or statutory debt
limitation. This contract shall not directly or indirectly obligate Pitkin County to make any payments
beyond those appropriated for Pitkin County's then current fiscal year. No provisions of this
contract shall be construed to pledge or create a lien on any class or source of Pitkin County's
moneys, nor shall any provision of this contract restrict the future issuance of Pitkin County's bonds
or any obligations payable from any class or source of Pitkin County's money.
20. Notice. Any written notice required by this contract shall be deemed delivered through any of
the following: (1) hand delivery to the person at the address below; (2) delivery by facsimile with
confirmation of receipt to the fax number below; or (3) within three (3) days of being sent certified first
class mail, postage prepaid, return receipt requested addressed as follows:
A. To Pitkin County with copies to:
Jim Elwood Pitkin County Attorney's Office
0233 E. Airport Rd. Ste. A 530 E. Main Street, #302
Aspen, Colorado 81611 Aspen, Colorado 81611
970 - 920 -5378 Fax: (970) 920 -5198
B. To Contractor:
Douglas Kuelpman
ADK Executive Search
PO Box 330906
Atlantic Beach, Fi.
21. Illegal Aliens — Public Contracts for Services. In conformance with the provisions of C.R.S.
§ 8- 17.5 -101 and 102, as amended;
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A. Contractor shall not knowingly employ or contract with an illegal alien to perform
work under the public contract for services.
B. Contractor shall not 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 the public contract for services.
C. Contractor has confirmed the employment eligibility of all employees who are newly
hired for employment to perform work under the public contract for services through participation in
either the E -Verify Program or the Department Program.
D. Contractor shall use either the E -Verify Program or the Department Program
procedures to undertake pre - employment screening of job applicants while the public contract for
services is being performed.
E. Should Contractor obtain actual knowledge that a subcontractor performing work
under the public contract for services knowingly employs or contracts with an illegal alien,
Contractor shall be required to:
1. 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;
2. Terminate the subcontract with the subcontractor if within
three days of receiving the required notice the subcontractor does not stop
employing or contracting with the illegal alien; except that the contractor shall
not terminate the contract with the subcontractor if the subcontractor provides
information to establish that the subcontractor has not knowingly employed or
contracted with an illegal alien;
F. Contractor shall comply with any reasonable request by the department made in the
course of an investigation that the department is undertaking pursuant to
C.R.S. 8- 17.5- 102(5).
IN WITNESS WHEREOF, the parties have executed this contract as of the date first set out herein
above.
CONTRACTOR: PITKIN COUNTet, • ORADO
BY: w, i 0 i _ _ .� ' BY:, T i . MI _
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Title 1 (d (\. la( 21 i I Title: 1 r 4, ,'- 10, = _ 1Z. 61
Date Date
8
•
SEARCH
Sjeciq t trig ExctusJw 1y lit AErgi rts
J
AGREEMENT
between
ADK CONSULTING, INC. dba ADK EXECUTIVE SEARCH
and
• PITKIN COUNTY
Executive Search for Assistant Director of Aviation Administration
Backttround
Pitkin County (County) has requested that ADK Consulting, Inc. dba ADK Executive
Search (ADK) provide professional services and assistance in the recruitment of a new
Assistant Director of Aviation- Administration for the Aspen/Pitkin County Airport (ASE).
Proposal •
ADK will perform an executive search for this position in accordance with its Proposal for
Executive Search Services dated October 27, 2011, as amended by this Agreement. As
outlined in the proposal, the County will assist in this process by assuming portions of the
search process including telephone interviews, reference checking, and final interviews.
Communications
The County has appointed Jim Elwood, Airport Director, as representative for all
communications between ADK and the County and Dannette Logan, Human Resources
Director, as his backup. Ail communications will be handled by electronic mats andlor
telephone, as far as practicable. All communications to ADK will be through Mr. Douglas
Kuelpman, President, with Ms. Armen Kuelpman, Vice - President, as backup.
1
•
Fee Proposal
The professional fee for this work scope rendered by ADK is fixed -price at $16,500.00 and
paid as follows: •
• Installment 1 of $8,500.00 is due within 30 days of contract signing per position.
• Installment 2 of $8,000.00 is due upon contract completion per position.
While ADK has not been requested to perform telephone interviews, reference checking, In-
person field interviews, or final interview support, ASE may decide to ask for these services at
a future date. Optional prldng for these Items are as follows and would be prorated into the
installments above:
• Telephone interviews with summary reports for up to ten candidates are priced at
$5000.00 Iump sum.
• Reference checks for 6 candidates are priced at $1500.00 lump sum.
• In- person interviews for 6 candidates are priced at $4000.00 (plus travel- related
expenses).
• Final interview development and on -site participation is priced at $3500.00 Iump sum
(plus travel- related expenses)
if requested to travel for this search to meet with County officials, for final interviews, or for in-
person Interviews, for example, ASE will be responsible for any reasonable and customary
incidental expenses for travel, lodging, meals, etc. ADK travels by coach class and stays In
moderately priced hotels (Hampton Inn, Marriott Courtyard, etc.).
If ADK Is requested by ASE to provide criminal /credit/education /motor vehicle background
checks, the fee will be $300.00 per candidate. We recommend that background checks be
completed prior to final interviews, regardless of who performs the checks. Many airport
owners prefer to use our services rather than their own policing agency to maintain
confidentiality for the candidates_
Schedule
Upon execution of an Agreement or a formal notice to proceed, a timeline will be provided by
ADK to allow County to monitor /plan for the various elements of this process.
Contract Completion
For purposes of this Agreement, contract completion means a list of recommended and
approved candidates for County to interview has been delivered to County upon the
completion of Phase 2 of the Proposal.
insurance
ADK hereby certifies that it possesses a comprehensive general liability policy with The
Hartford a professional services liability policy with the Philadelphia Insurance Companies.
Evidence of insurance will be delivered to the County upon request.
2
lD
Indemnification
ADK shall indemnify and hold harmless the Board, its employees, and associates from
any and all liabilities. costs or damages (including reasonable attorneys' fees) that may
arise from any action or inaction of its employees, associates, and Board members in
connection with the performance of the services outlined herein, except for such liabilities,
costs or damages which are due to the gross negligence or willful or intentional
misconduct of the Board, its employees, and associates. -
Termination
Both parties retain the right to terminate this Agreement at any time with 30 days prior
written notice. Upon termination notice, ADK will.cease work and provide documentation
of work completed to date of termination. ADK will be compensated for all activity
(professional fees) and expenses that have been obligated at the date of termination per
the terms of this Agreement, on a pro -rata basis.
Notices
Any and all notices required to be given by either of the parties hereto shall be In writing
and be deemed communicated when mailed in the United States mail, certified, return
receipt requested, addressed as follows:
Jim Ellwood Douglas R Kuelpman
Airport Director President
Pitkin Government ADK Executive Search
530 E. Main Street PO Box 330906
Aspen, Colorado Atlantic Beach, FL 32233
Agreed to;
Signature (wood, rport Director Date
Pi in County
Signature Do R Kuelpman, Pres • =nt Date
ADK Consulting, Inc. dba ADK Executive Search
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Contract # 9/27/11 kj/Im
Budget Line Item#
TK 11
+o u
i
Workers' Compensation Waiver
Sole Proprietorships or Partnerships:
I, , as sole proprietor or partner of business
name), represent that I have no person or persons in my employ, but that I 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 I may employ in performing any work
in the future. I shall also require any subcontractor as I may contract with or obtain for any
work to maintain workers' compensation protection for its employees.
Contractor Signature Date
Print Name
Corporations:
1, Douglas R Kuelpman , in my capacity as President (title)
of ADK Consulting, Inc. (corporation name) represent that ADK Consulting, Inc.
(corporation name) has no person or persons in its employ and that each stockholder of
ADK Consulitng, Inc. (corporation name) owns at least 10% of ADK Consulting, Inc.
's (corporation name) stock, but that ADK Consulting, Inc.
(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. ADK Consulting, Inc.
(corporation name) shall also require any subcontractor it may contract
with or obtain for any work to maintain workers' compensation protection for its
- l • loye
DEC • . - _ • y ad `,_ DEC 2, 2011 • . = or Signature Date
Douglas R Kuelpman
Print Name
)7/