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pifKIN Pitkin County
CouNT1/ Contract Cover Sheet
Please complete the Contract Cover Sheet when the contract is completed and signed by Contractor and Pitkin County
Project Manager.
Return all Contract Cover Sheets and Contracts/Change Orders/Amendments to Procurement
(procurement_help@,pitkincounty.com).Any contracts$50,000 and over will be routed for signatures to County Manager
and Attorney's Office(if required)by Procurement&Contracts Manager.
Contract Information
Contract Number 243.2015A
Project Name Mechanical&Plumbing Engineering Services
Contractor SGM,Inc.
Budget Line Item 001.17.00928.82000
Additional Budget Line Item(s) 001.34.00928.82000
and special notes to Finance _
Contract Start Date 12/14/2015
Contract End Date 2/29/2016
Automatic Renewal Yes ❑ No—
If Construction: Retainage Click here to enter text.
If this is a new contractor,please request they complete and submit to Finance a W-9 Form.
Contact Information:
Department Facilities
Project Manager Jodi Smith Project Manager 920-5396
Phone
Provide a brief description of the contract:
Mechanical and Plumbing engineering services for jail and courthouse facility upgrades.
Amendment A: Language necessary for work in jail added.
Contract Value Summary:
Contract Amount $7,850.00
This Change order/Amendment amount(if applicable)
New Contract Total
Procurement Method:
None ►Z Informal CI Formal ❑ Sole Source 0 Emergency❑ Contract Renewal 0
Contract Type:
Services/Maintenance _1 Construction ❑ Goods,Equipment, Supplies ❑
Change Order/Amendment ❑ Other,please explain 0 Click here to enter text.
NOTE: CLERKS OFFICE WILL KEEP ORIGINAL DOCUMENTS IN COMPLIANCE WITH COLORADO STATE
ARCHIVES RETAINAGE SCHEDULE.ALL ATTACHMENTS MUST BE WITH THIS CHECKLIST.
Contract#243.2015 Rev. 8.31.11 jaa/s
Budget Line Item#Various
rjr 1" 114
ve
N "4;
CHANGE ORDER/CONTRACT AMENDMENT
Change Order Number: 243.2015A
OWNER: Pitkin County Facilities
485 Rio Grande Place,#101
Aspen,Colorado 81611
CONTRACTOR: SGM,Inc.
The Provision of Mechanical and Plumbing Engineering Services for the Jail and Courthouse(the
"Agreement") dated 12/9/2015 between the Board of County Commissioners of Pitkin County (the
"County")and SGM,Inc. (the"Contractor"), is hereby amended as follows:
Description of Change:
a. 22. Prison Rape Elimination Act(PREA) Requirements per DOJ §115.17
The contractor asserts that they have not:
• Engaged in sexual abuse in a prison,jail, lockup, community confinement facility,juvenile
facility, or other institution(as defined in 42 U.S.C. 1997)
• Been convicted of engaging or attempting to engage in sexual activity in the community
facilitated by force, overt or implied threats of force, or coercion, of if the victim did not consent
or was unable to consent or refuse; or
• Been civilly or administratively adjudicated to have engaged in the activity described.
Pitkin County does hereby certify that all contractors whom may come into contact with inmates
are required to undergo a criminal background check and the Contractor has complied with this
requirement.
Reason for Change:
a. Necessary language for all work in the jail omitted from original contract.
Original Contract Price $ 7,850.00
Net Increase/Decrease in Contract Price(this change order) $0.00
*Total Adjusted Contract Price(including this change order) $ 7,850.00
In all other respects the Agreement is in full force and effect and remains unchanged by this
Amendment.
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Rev 12/27/10 js
Project Coding Original Contract#
,?-14.41 12/18/2015
Tony Haschke, S ,Inc. Date
4)4( r2424/1 )
Jodi Stth,Facilities Superintendent Dat
*Increases over$25,000 and/or 10% (single increase or accumulative) of original contract must have
County Manager signature.
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