HomeMy WebLinkAboutbocc.con.197.2013 Rev. 08-30-11jts'
.1101
. COUNTY CLERK'S
CONTRACT COVERSHEET
CONTRACT #: /47 a O/ 3
ORIGINATING DEPARTMENT:L✓lira M
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PROCUREMENT OFFICER: PHONE#: /110.47-190,Z5
PROJECT NAME: l ''CONTRACTOR: Are �/l�r`�PQ 617
DOLLAR AMOUNT:I3 ddd LINE/ITEM#166.9_ _ 00000 2
0
CONTRACT EXECUTION DATE: ¶/y/1g CONTRACT END DATE: 7/y,/3
AUTOMATIC RENEWAL: ❑ YES ((( [[[ NO TERM: l
❑ 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)
V CHECK PROCUREMENT TYPE:
❑None Xi Informal , ❑ Formal ❑ Sole Source El Emergency ❑ Outside Agency/State Bid
❑ Compliance with C.R.S. 8-17-5-101, 102 as amended(Immigration Form) ❑ Exempt
❑ Contract Renewal
V CHECK CONTRACT TYPE:
Services/Maintenance ❑ Employment
❑ License/Use El 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(if applicable)
. ✓ ❑ All Original Signatures Affixed ✓❑Notice of Award/Notice to Proceed Attached (if applicable
✓ El All Dates Filled In ✓❑ Warranty(if applicable) •
✓ ❑ Special Instructions for Finance Department:P ece ejack—J i a- ik Zet4/1 •
✓ ❑ Authorized Procurement Officer's Name: O
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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!
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Contract# Rev. 12/27/10 j is
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LETTER OF ENGAGEMENT
April 19, 2013
Project Name: "Dig This: Stories that ROCK!" Storytelling Performance
Business Name: Christopher Leebrick
1567 Holly Street
West Linn, OR 97068
Re:Summer Children's Program: 2013
Dear Christopher,
The purpose of this fetter 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.
You will perform "Dig This: Stories that ROCK!" for children ages 5-10 on
Tuesday, July 9, 2013 at 1:00 p.m. at the Pitkin County Library. You will arrive at
least 30 minutes in advance. The program will last approximately one hour. Your fee
will be $300. A check for that amount will be issued and paid at the time of the
performance. All other expenses shall be yours.
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
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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 3151 and will require a new document in succeeding years to be
effective. You acknowledge and agree that you shall not be entitled 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 O
Contract# Rev. 12/27/10 j Is
Ledger#
Sin rely,
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Si
an Keenan, Children's Librarian •
STATE OF COLORADO )
) ss.
COUNTY OF PITKIN )
The forgoing instrument was acknowledged before me this a y of/Re/(,r70/4 by
Susan Keenan
Witnessed my hand and official seal.
My commission expires: j-17-71/
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Not. '�ic Rci,TARY
AG' • 'a /. 10 tt. f+1181IG rp
opher „„OFC -at,
STATE OF OREGON )
) ss.
COUNTY OF Cacti-aunt&S )
The forgoing instrument was acknowledged before me this 11 day of , t3 by
Christopher Leebrick. noon year
Witnessed my hand and official seal.
My commission expires: a\ 0 $,'2D\,o
Notary Pub
OFFICIAL SEAL
PAMELA)WA7TERUD
NOTARY PUBLIC-OREGON
COMMISSION NO.472454
MY COMMISSION EXPIRES OCTOBER 08,2018
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