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Home My WebLink Aboutbocc.con.182.2011 Rev. 08-29-11 COUNTY CLERK'S CONTRACT COVERSHEET CONTRACT #: V1 ORIGINATING DEPARTMENT: Library PROCUREMENT OFFICER: Genevieve Smith PHONE #: - 4291948 PROJECT NAME: Corsage Making CONTRACTOR: Jennifer Tindall DOLLAR AMOUNT: $$200.00 LINE ITEM # CONTRACT EXECUTION DATE: 9/28/2011 CONTRACT END DATE: 9/28/2011 AUTOMATIC RENEWAL: ❑ YES ® NO TERM: 1 Day ❑ 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) ['Letter of Engagement ❑ Contract Renewal +� CHECK CONTRACT TYPE: ® Services/Maintenance ❑ Employment ❑ License/Use ['Intergovernmental Agreement (Resolution Required) 111 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 (if applicable) ▪ ® All Original Signatures Affixed ✓® Notice of Award/Notice to Proceed Attached (if applicable ® All Dates Filled In ✓® Warranty (if applicable) ® Special Instructions for Finance Department: Please give check to Genevieve Smith @ Library ® Authorized Procurement Officer's Name: Genevieve Smith BY CHECK.IN(. ABOVE AND ENTERING NAME, T.H..E AUTHORIZED STAFF PERSON IN.DIC.'ATES `1 HAT THE ATT =OOHED 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 # Rev. 12/27/10 jls Ledger # e 'gyp .s "� C4101100 LETTER OF ENGAGEMENT September 20, 2011 Jennifer Tindall 170 Forge Rd #106 Aspen, CO 81615 Re: Corsage Making Dear Ms. Tindall: 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. As a professional florist, you will work with young adults in a program entitled "Corsage Making ". The program will last two hours on Wednesday, September 28 Please arrive at least 30 minutes in advance. Your fee will be $200 plus the cost of materials. It will be paid to you at the time of the program. 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 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 standards 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 will terminate on December 31 and will require a new document in succeeding years to be effective. You acknowledge and agree that you shall not be ent 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. 1 Contract # Rev. 12/27/10 jls Ledger # Illegal Aliens — Public Contracts for Services In conformance with the provisions of C.R.S. § 8- 17.5 -101 and 102, as amended; 1. Contractor shall not knowingly employ or contract with an illegal alien to perform work under the public contract for services. 2. 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. 3. 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. 4. 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. 5. 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: (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; (b) 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; 6. 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). If you are 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. 2 3 Contract # Rev. 12/27/10 jls Ledger # Sincerel Genevieve . mit , Young • dult Services Librarian STATE OF COLORADO ) ) ss. COUNTY OF PITKIN ) The forgoing instrument was acknowledged before me this ) day of September, 2011 by Genevieve Smith Witnessed my hand and official seal. A My commission expires: i'() 1 l ) `-'. Notary Public ,::., ! 1 :..�' , AGREED: I ,s, -,,edit,• As I A 1 I Jennifer's • 1 ~ f STATE OF COLORADO ) ) ss. COUNTY OF PITKIN ) The forgoing instrument was acknowledged before me this a3 day of September, 2011 by Jennifer Tindall. Witnessed my hand and official seal. My commission expires: g 120 01c H t t 4kge,,AS Notary Public f•tV 4 4 • �p T AA rA�� I� 41 '�F COL O% rs 3 o c , Workers' Compensation Waiver Sole Proprietorships �� o � r � Partnerships I, hi`� , ds 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 o mai i f. in • rkers' ompensatio • • rotection for its employees. —.14/ii ik l A 4/ II , 1 0.-)' 20)) Co /. ■ for S gna - Da ' ii //Li Pri l ame Corporations I, , in my capacity as (title) of (corporation 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. Contractor Signature Date Print Name