HomeMy WebLinkAboutbocc.con.160.2015Rev. 08-30-11 jls
COUNTY CLERK'S
moor CONTRACT COVERSHEET
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CONTRACT #: &
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ORIGINATING DEPARTMENT: ra /',
PROCUREMENT OFFICER:PHONE #:
PROJECT NAME:CQNTRA OR.
DOLLAR AMOUNT: ��_5LINE ITEM # /
CONTRACT EXECUTION DATE: �/+ r�� CONTRACT END DATE: 6'/o A_
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)
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❑ Compliance with C.R.S. 8-17-5-101, 102 as amended (Immigration Form) ❑ Exempt
❑ Contract Renewal
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Services/Maintenance ❑ Employment
License/Use ❑ Intergovernmental Agreement (Resolution Required)
Lease ❑ Non -Profit
Construction ❑ Quasi -Public (e.g.-AVH)
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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
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✓Special Instructions for Finance Departmen . a/4-_
V11� Authorized Procurement Officer's Name:
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 jls
Ledger #
LETTER OF ENGAGEMENT
April 21, 2015
Project Name: He` in Magic performance
Business Name: kl Pstun
4' - Iris Court
D -neer, CO 80123
Re: Summer Children's Program 2015
Dear Dave,
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 "Heroes in Magic Show" for children ages 5-10 on
Tuesday, June 23, 2015 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 $225. 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 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.
Contract # Rev. 12/27/10 jls
Ledger #
Sincerely,
Susan Keenan, Youth Services Librarian
STATE OF COLORADO )
) ss.
COUNTY OF PITKIN )
The forgoing instrument was acknowledged before me this 21 1' day of . r; I, o1 ,by
Susan Keenan
.i�.. C
Witnessed my h ad official seal.
My commission es: 5 3j Notary Public
G
2 � � k�—
Dave Elstun
STATE OF COLORADO )
COUNTY OF 0Cj���'I ) ss.
The forgoing instrument was acknowledged before me this �qday of�*, ��y
Dave Elstun. Month year
Witnessed my hand and official seal.
My commission expires: 124/—'Z -(f 201-�L
ANASTASfYA A. TRUSH
NOTARY PUBLIC Notary Public
STATE OF COLORADO
NOTARY ID 20134024842
MY COMMISSION EXPIRES 04-24-2017