Loading...
HomeMy WebLinkAboutbocc.con.070.2015Rev. 08-30-11 jls COUNTY CLERK'S it/ CONTRACT COVERSHEET CONTRACT #: 7,D - 2—o (5� ORIGINATING DEPARTMENT: u M ten]eS o acct o PROCUREMENT OFFICER:?. PHONE #: 0120 - SLoe 5U 5 .,ca_v` ems, S'� •�o n PROJECT NAME: e 4,n f 4 CONTRACTOR: c�a y DOLLAR AMOUNTr 3 000 LINEITEM# V2 -0, 6(g,00000- gZOO1O CONTRACT EXECUTION DATE: oZ — l b - /CONTRACT END DATE: ( 3 I AUTOMATIC RENEWAL: ❑ YES C9NO TERM: 3 ✓v o ❑ 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 (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 ✓ If Page Left Intentionally Blank —Note on Page ✓ ❑ Page numbered consecutively ✓ © All Original Signatures Affixed ✓ ® All Dates Filled In ✓ ❑ Special Instructions for Finance Department: ✓ ❑ Authorized Procurement Officer's Name: ✓❑ All Other Blanks Filled In ✓Q All Exhibits Attached ✓❑ All Legal Descriptions attached (if applicable) ✓❑ Notice of Award/Notice to Proceed Attached (if applicable ✓❑ Warranty (if applicable) BY CHECKING ABOVE AND ENTERING NAME, THE AUTHORIZED STAFF PERSON 1 DICATES THAT THE ATTACHED DOCUMENT HAS BEEN PROOFED AND READY FOR SCANNINV /� I NOTE: CLERK'S OFFICE WILL KEEP ORIGINAL DOCUMENTS IN COMPLIANCE WITH COLORADO STATE ARCHIVES RETAINAGE SCHEDULE. ALL ATTACHMENTS MUST BE WITH THIS CHECKLIST! TK v j Coding: 420.98.00000.82000 co u NTs C / ; „ __— Contract: 170-2015 PITKIN COUNTY STANDARD FORM OF AGREEMENT February 201 I5 !. , BETWEEN the Board of County AGREEMENT made as of Fo day of COMMISSIONERS OF PITKIN COUNTY (the "BOCC") and 1Jucy Sutton (herein after called the "Contractor" to provide services for: Board of County Commissioners of Pitkin County C/0 Address 530 E Main St, 3rd Floor Aspen, CO 81611 Phone 970-920-5200 And the Professional (Contractor Info): Name Judy Sutton Address 98 Newberry Rd, South Windsor, CT 06074 Phone 860-930-5326 { Email jsutton@cox.net Contract Amount: $ 3,000 Project Insurance Process Training Name: Scope of services detail attach as exhibit below Exhibits as appended and made a pan of this Agreement: ExhibitA Proposal=forPitkmC=ounty This agreement will terminate on April 30 2015 and will require a new documentation in succeeding years to be effective. 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 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. PUBLIC CONTRACTS FOR SERVICES. CRS §8-17.5-101. [Not Applicable to agreements relating to the offer, issuance, or sale of securities, investment advisory services or fund management services, sponsored projects, intergovernmental agreements, or information technology 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 and will confirm the employment eligibility of all employees who are newly hired for employment in the United States to perform work under this contract, through participation in the E -Verify Program or the Department 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. Aglee.t Pagel 4kr COVNT4� Contractor (a) shall not use E -Verify Program 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 course of an investigation, undertaken pursuant to CRS §8-17.5-102(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 shall be liable for damages. PUBLIC CONTRACTS WITH NATURAL PERSONS. CRS §24-76.5-101. 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 lawfully 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. Phylis Mattice Name of Representative for Pitkin County Name of Authorized Contractor Representative Al�ras� P.p2 2-19-15 Signatty Date S !f ure ate Proposal for Pitkin County February 4, 2015 Training Assessment— Risk Management: Summary of conversations with Ximena Hulslander and Laura Maker 1) Safety Manual a) Review manual for latest edition/update b) Recommend revisions for complete data capture and to meet reporting needs to support TPA c) Identify gaps in 1^ notice reporting 2) Contact CCMSI —Ann Marie Evans a) Outline TPA expectations for incident reporting — by type of claim, value thresholds and required timeframes b) Review tools used to ensure consistency in data capture and reporting c) Identify what data and reporting tools are available to support follow-up and data analysis 3) Review insurance contracts — (One Beacon and others as applicable) a) Identify and organize policy information b) Provide overview of the terms and conditions c) Identify expectations for reporting and communication with One Beacon (Contact David Schwartz) 4) Document process to support best practices for ongoing Risk Management and Safety a) Define roles and responsibilities of each Broker, TPA and Ximena for managing Risk and Safety b) Outline process to Improve communication flow c) Identify or develop tools to support data capture and reporting Training Proposal: Three day onsite interactive training to address the Property and Casualty Training specific to the role of the Human Resources Technician Safety and Risk Management; Ximena Hulslander. Included in the scope of training are the items listed above; 1) a, b, c : 2) a : 3) a, b, c Outside of scope are items 2) b, c :4) a, b, c. : While outside of scope there may be overlap with the P&C specific training and some additional definition may be documented during the onsite training. These Items can be articulated and then addressed with a new contract for future work based upon mutual agreement of the parties.