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Home My WebLink Aboutbocc.con.199.2013 Rev. 08-30-11jis lit • COUNTY CLERK'S CONTRACT COVERSHEET CONTRACT #:/%79 V 0/3 ORIGINATING DEPARTMENT: O'' .,, l PROCUREMENT OFFICER:5u9n eeeh ,PHONE#: "7,9J- /9a" /S PROJECT NAME: 5(tlhlnr&dir4015 CONTRACTOR: Ah I h .lv,eari DOLLAR AMOUNT: WASO C LINE ITEM# /�66,a —oda00 _ R d21 CONTRACT EXECUTION DATE (g, J3 CONTRACT END DATE: / D/,�j AUTOMATIC RENEWAL: ❑ YES kNO TERM: ❑ BOCC AGENDA ITEM (Grants, IGA) Ai 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 (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:'" flee e O Iv P, k- 4 &4SeZ' t /7 a h ✓ ❑ Authorized Procurement Officer's Name: 1 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# Rev. 12/27/10 j is Ledger# mss, �r ' 1,. tr . to .ri++w ,r^ t , ' rN:t" .lt *:'Cltiy .„- ps,y, Vn LETTER OF ENGAGEMENT April 19, 2013 Project Name: Dino Girl Magic and Juggling Show Business Name: Ann Lincoln 1833 Clermont Street Denver, CO 80220 Re:Summer Children's Program 2013 Dear Ann, 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. You will perform your "Dino Girl Magic and Juggling Show” for children ages 5- 10 on Tuesday, July 30, 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 $250. 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 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 311 and will require a new document.in,succeeding-yearsdo be effective.. You acknowledge:and agree th'afyou 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 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. Sincerely, 2 Contract# Rev. 12/27/10 jls Ledger# ./ / i�// usan Keenan, Children's Librarian STATE OF COLORADO ) ) ss. COUNTY OF PITKIN ) / The forgoing instrumentwas acknowledged before me this/-t C of Pi#// .°20/- by Susan Keenan Witnessed my hand and official seal. My commission expires: — al/ iP�MIE pR� Ns a 'ublic r 0. q)- ,pS : LA' r AGREED• S Ann Lincoln � v II'9�pF�`�Ot0��_ STATE OF COLORADO ) �) ss. COUNTY O� ) The forgoing instrument was acknowledged before me this O day of it/011-y, 2_6010,Aim A Lincoln. Month year S antrtittitoes Witnessed my hand and official seal. ''�oiy� ,... . My commission expires: � /8 , l do m� :it a No ary Publi • r. . •• ®tr' 3