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Home My WebLink Aboutbocc.con.310.2012 Rev. 08-30-I1 jls COUNTY CLERK'S CONTRACT COVERSHEET CONTRACT #: 310-2012 ORIGINATING DEPARTMENT: Human Services PROCUREMENT OFFICER: Kim Dubois PHONE#: 4292043 PROJECT NAME: Translations and Interpretation for Bilingual Child Welfare clients CONTRACTOR: Andrea Aliaga DOLLAR AMOUNT: 7 500.00 LINE ITEM# 112.43.94620.82000 CONTRACT EXECUTION DATE: 12/19/2012 CONTRACT END DATE: 12/31/2012 AUTOMATIC RENEWAL: � YES ❑ NO TERM: ❑ 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. 8-17-5-161, 102 as amended(Immigration Form) ❑ Exempt ❑ Contract Renewal � L ,Q4/�Q,O �8'3"� ✓ CHECK CONTRACT TYPE: � r-Vd � 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(ifapplicable) ✓ � 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: pay upon approval of AFS manager ✓ � Authorized Procurement Officer's Name: Kim Dubois 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! ' Coding: 112.43.94620.82000 Contract: 310-2�12 PITKIN COUNTY STANDARD FORM OF AGREEMENT AGREEMENT made as of �� day of December 2012, BETWEEN the Board of County COMMISSIONERS OF PITKIN COIJNTY(the "BOCC") and Andrea Aliaga (herein after called the "Contractor"to provide services for: Board of County Commissioners of Pitkin County Contract Amount: $ 7,500 C/O Kim DuBois,AFS Manager Address 0405 Castle Creek Road,Suite 8 Project Translation and Interpretation for Bilingual Child Aspen,CO 81611 Name: Welfare Clients Phone (970)429-2043 Scope of services detail attach as exhibit below And the Professional(Contractor Info): Exhibits as appended and made a part of this Agreement: Name ttac ment 1 Andrea Aliaga Exhibit A cope of Work and Budget Address ranslation and Interpretation Services Phone (614)439-3658 E-mail aaliaga@live.com This agreement will terminate on 12/14/2013 and will require a new documentation in succeeding years to be effective. The purpose of this agreement is to summarize the pertinent terms of Pitkin County's arrangement with you. 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. 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 scope of work. The County representative signing this letter is available to you to discuss any details related to this agreement. You acknowledge and agree that you shall not be enNtled to workers' compensation benefits in connection with this project and that you shall be responsible for the payment of all state and federal income tages. You shall obtain, and maintain continuously for the term of this arrangemen at our own expense, occurrence form Commercial General Liability with limits of $1,000,000 Each Occurrence, $1,000,000 General Aggregate and $1,000,000 products/Completed Operations Aggregate including an endarsement naming the County as an additional insured (for ongoing operations and completed operations) and/or other insurance to indemnify the County for the activities and services of this of this arrangement. You are not relieved of any liability or other obligations assumed pursuant to this arrangement by reason of your failure to obtain or maintain insurance or by reason of your failure to procure or maintain insurance in sufficient amounts,durations,or types. I Agreement for Services 1 Page I , PUBLIC CONTRACTS FOR SERVICES.CRS§8-17.5-102. [NotApplica6le to agreements re[ating to the offer,issuance, or sale of securities, investment advisory services or fund management services, sponsored projects, intergovernmental agreements, or information technoingy services or products and services] Contractor certifies, warrants, and agrees that it does not knowingly employ or contract with an illegal alien who will perform work under this contract a.nd will confirm the employment eligibility of a11 employees who aze newly hired for employment in the United States to perform work under this contract, through participation in the E-Verify Program or the Departrnent program established pursuant to CRS §8-17.5-102 (5)(c),Contractor shall not knowingly employ or contract with an illegal alien to perform work under this contract or enter into a contract with a subcontractor that fails to certify to Contractor that the subcontractor shall not knowingly employ or contract with an illegal alien to perform work under this contract.Contractor(a)shall not use E-Verify Progam or Department program procedures to undertake pre-employment screening of job applicants while this contract is being performed,(b)shall notify the subcontractor and the contracting State agency within three days if Contractor has actual knowledge that a subcontractor is employing or contracting with an illegal alien for work under this contract,(c}shall terminate the subcontract if a subcontractor does not stop employing or contracting with the illegal alien within three days of receiving the notice, and (d) shall comply with reasonable requests made in the cowse of an investigation, nndertaken pursuant to CRS §8-1'7.5-102(5), by the Colorado Department of Labor and Employment. If Contractor participates in the Department program, Contractor shall deliver to the contracting State agency,Institution of Higher Education or political subdivision a written,notarized affirmation,affirming that Contractor has examined the legal work status of such employee, and shall comply with all of the other requirements of the Department program. If Contractor fails to comply with any requirement of this provision or CRS §8-17.5-101 et seq., the contracting State agency, institution of higher education or political subdivision may terminate this contract for breach and, if so terminated,Contractor sha11 be liable for damages. PUBLIC CONTRACTS WITH NATURAL PERSONS. CRS §2476.5-101. Contractor, if a natural person eighteen (18) years of age or older, hereby swears and affirms under penalty of perjury that he or she (a) is a citizen or otherwise lawfuIly present in the United States pursuant to federal law, (b)shall comply with the provisions of CRS §24-76.5-101 et seq., and(c) has produced one form of identification required by CRS§24-76.5-103 prior to the effective date of this contract. � Name of Representative for Pitkin unty STATE OF COLORADO ) )ss. COUNTY OF PITKIN ) The forgoing instrument was acknowledged before me this�day o�, te �2012,by l f�4 . !7 �l� � Witnessed my hand and official seal. My commission expires: �� c� �G o blic AGREED: �� I��.ln�� .�.QQ_ O�TARY UBUC Name of Authonzed Contractor Representative � � STATE OF COLpqqDO STATE OF COLORADO ) �COMMIS$ION p(PIpE�g p3,pg.�g )ss. ��tsi�i�� COUNTY OF PITKIN ) �� e A• A� �i� ;��,,,.......,he� �'': The forgoing instrument was acknowledged before me thisr,��day of��(,2012,by �(.l.v'LC-w � � �� : w � a � �rO+ Wimessed my hand and official seai. � � ��,1G ` My Commission Expires ° J''�.,• ,�� o� My commission expires: n„n„ct d 2015 � � � '��`N�o""�a�o"��`� AgreementforServices 40�PUbI1C ��/ \�� / f �` 1 `♦ Page 2 �Ifl11l� 'L �. �.w.� __.._�,_. r,__,...�-..�.��.� � � ��., �,�._u„.. �..� Attachment A: Scope of Services for Translation for Child Welfare Clients 1. Consultation for Child Welfare Staff re: case specific information 2. Translation Services for Clients(Emergency,Assessments and Ongoing Cases) 3. Any follow-up required as necessary and agreed upon between PCDHS staff and contractor 4. 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 Paragraph 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$7500.00 for all services rendered. Contractor sha[1 invoice for the project weekly or monthly based on hours worked at$35.00/hour with payment expected within thirty(30)days of invoice,but any payment by the County may be offset by any amount the Contractar owes the County for any reason. Travel time should be included in the invoice in the per hour cost. � Contract# � 9/27/11 kj/lm Budget Line Item# Workers' Compensation Waiver Sole Proprietorships or Partnerships I, Gl , as sole proprietor or partner of business name), represent I have no person or persons in my employ, but that I sha11 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 Colora.do 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�T � n��'Q,O� C i aA 0. Print Name 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 Colora.do 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 1