HomeMy WebLinkAboutbocc.con.161.2015Rev. 08-30-11 jls
COUNTY CLERK'S
CONTRACT COVERSHEET
CONTRACT #:
ORIGINATING DEPARTMENT: Emergency Dispatch Center
PROCUREMENT OFFICER: Bruce Romero PHONE #: 970.315.2184
PROJECTNAME: PUC - NDA CONTRACTOR:
DOLLAR AMOUNT: $0.00 LINE ITEM #
CONTRACT EXECUTION DATE: 6/19/2014 CONTRACT END DATE:
AUTOMATIC RENEWAL: ❑ YES ® NO TERM: Indefinite
❑ 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
✓❑ All Exhibits Attached
✓❑ All Legal Descriptions attached (f applicable)
✓❑ Notice of Award/Notice to Proceed Attached (if applicable)
✓❑ Warranty (if applicable)
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!
BEFORE THE PUBLIC UTILITIES COMMISSION OF THE STATE OF COLORADO
PROCEEDING NO. 131-1147T
IN THE MATTER OF INQUIRY INTO E9-1-1 NETWORK PERFORMANCE DURING RECENT
FLOOD AND FIRE RELATED DISASTERS IN THE STATE OF COLORADO
NONDISCLOSURE AGREEMENT
I hereby state that I have read the protective provisions relating to confidential information
contained in Rules 4 CCR 723-1-1100-1103 and agree to be bound by the terms of those protective
provisions with respect to all evidence and information produced or arising in the course of this
Proceeding No. 13I -1147T.
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Name
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Party in Case
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