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COUNTY CLERK'S
CONTRACT COVERSHEET
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CONTRACT #: 070-2010-B �
ORIGINATING DEPARTMENT: Health&Human Services
PROCUREMENT OFFICER: Mitzi Ledingham PHONE#: 9205766
PROJECT NAME: HCF Grant Programs CONTRACTOR: The Buddy Program
DOLLAR AMOITNT: $25,000.00 LINE ITEM# 113.85.00000.84014
CONTRACT EXECUTION DATE: 1/1/2012 CONTRACT END DATE: 12/31/2012
AUTOMATIC RENEWAL: ❑ YES �NO TERM: partnership
❑ 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:
❑ 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
(GO: 10%ar$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 E�ibits Attached
✓ � Page numbered consecutively ✓� All Legal Descriptions attached(fapplicable)
✓ � 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: see contract payment worksheet
✓ � Authorized Procurement Officer's Name: Mitzi Ledingham
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 WII.,L KEEP ORIGINAL DOCUMENTS IN COMPLIANCE WITH COLORADO STATE
ARCHIVES RETAINAGE SCHEDULE. ALL ATTACHMENTS MUST BE WITH THIS CHECKLIST!
Contract# 070-2010-B
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CHANGE ORDER/CONTRACT AMENDMENT
Change Order Number: 2 Ledger No. 113.85.00000.84014
OWNER: Pitkin County HHS
c/o Mitzi Ledingham .
0405 Castle Creek Rd. suite 7
Aspen, CO 81611
CONTRACTOR: The Buddy Program
110 E. Hallam, Suite 125
Aspen,CO 81612
Attn: Director Catherine Anne Provine
The 2010-2012 The Buddy Prograin partnership grant agreement (the"Agreement") dated Januarv 1 st,
2010 between the Board of County Commissioners of Pitkin County (the "Count�') anci The Buddy
Program(the"Contractor"),is hereby amended as follows:
� Description of Chan�e: continuation of contract terms for 2012 as written at same funding level. $9,000 of
the$25,000 allocation,previously extended for a 12-month term in 2011,has beeu approved to be added to
the$16,000 base partnership allocation,making the total partnership allocation$25,000 for 2012.
Reason for Chan e��, third year of three year partnership agreement
Original Contract Price $ 25,000
Net Increase/Decrease in Contract Price(this change order) $ same level throu�h Dec 2012
Tota1 Adjusted Contract Price(including this change order) $ same level through Dec 2012
In all other respects the Agreement is in full force and effect anc3 remains unchanged by this
Amendment.
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Contractor ate
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Authorized County epresentative Date
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