HomeMy WebLinkAboutbocc.con.amended.395.2016 EUpdated renewal.
2017-11-13 btf
Pitkin County
Procurement Cover Sheet
Please complete the Contract Cover Sheet when the contract/task order is complete and fully executed.
Return all Contract Cover Sheets and Contracts/Change Orders/Amendments/Task Orders to Procurement
Contract Information
Contract Number 395.2016 E
Project Name Signature and Workflow Technology
Contractor Carahsoft
Budget Line Item 10022100.576500 $ -
Additional Budget Line
Item(s)
(Please fully allocate New Contract Total)
$ -
$ -
$ -
$ -
Procurement Method: None
Type: Services/Maintenance
Contract Start Date 12/21/2016
Contract End Date 08/12/2021
Contract Type Change Order/Contract Amendment
Retainage No
If this is a new contractor, please request they complete and submit to Finance a New Vendor Request Form.
Contact Information:
Department BITS
County Representative Carrie Fleischman County Representative
Phone (970) 319-2513
Contract Value Summary:
Original Contract Amount $ 11,445.00
Previous Change Order/Amendment Amount $ 115,455.94
This Change order/Amendment amount $ 33,652.22
New Contract Total $ 160,553.16
NOTE: Clerks Office will keep original documents in compliance with Colorado State Archives retainage
Provide a brief description of the contract:
Contract #: 395.2016
Budget Line Item #: 10022100.576500
CHANGE ORDER / CONTRACT AMENDMENT
Change Order Number: 395.2016 E
Rev. 2018.06.13 btf
OWNER:
Pitkin County, Colorado
530 E. Main St., Suite #302
Aspen, CO 81611
CONTRACTOR:
Carahsoft
11492 Sunset Hills Road, Suite 100
Reston, VA 20190
The Provision of Signature and Workflow Technology (the “Contract”) dated December 20,
2016 between the Board of County Commissioners of Pitkin County, Colorado (the “County”)
and Carahsoft (the “Contractor”), is hereby amended as follows:
Description of Change:
Update Scope of Services to reflect:
1.Modification of software licensing to include 7,500 envelopes; quoted at $29,262.75 for the term
ending August 12, 2021
2.Downgrade to Enterprise Support through August 12, 2021, from Premier support; quoted at
$4,389.47
Reason for Change:
1.Renewal/extension of contract term through August 12, 2021 per the attached quote
2.Downgrade of support for savings.
Original Contract Amount $ 11,445.00
Previous Change Order/Amendment Amount $ 115,455.94
This Change Order/Amendment Amount $ 33,652.22
New Contract Total $ 160,553.16
*Increases over $25,000 and/or 10% (single increase or accumulative) of original contract must
have County Manager signature. 1
Contract #: 395.2016
Budget Line Item #: 10022100.576500
Rev. 2018.06.13 btf
In all other respects, the Contract is in full force and effect and remains unchanged by this
Amendment.
CARAHSOFT
____________________________________________________________________________
Date
PITKIN COUNTY, COLORADO
RECOMMENDED FOR APPROVAL:
____________________________________________________________________________
Date
MANAGER APPROVAL:
____________________________________________________________________________
Date
Interim IT Director
Carrie Fleischman
Aug-24-2020
Renewal specialist
Aug-24-2020
Kimberly Barrera
Aug-31-2020
Deputy County Manager
Rich Englehart
Date
*Increases over $25,000 and/or 10% (single increase or accumulative) of original contract must
have County Manager signature. 3
Government - Price Quotation
DocuSign Government at Carahsoft
11493 SUNSET HILLS ROAD | Suite 100 | Reston, Virginia 20190
Phone (703) 871-8500 | Fax (703) 871-8505 | Toll Free (888) 662-2724
www.carahsoft.com | sales@carahsoft.com
Cage Code: 1P3C5
Credit Cards: VISA/MasterCard/AMEX
Sales Tax May Apply
TOTAL PRICE:
$35,685.00
TOTAL QUOTE: $35,685.00
LINE NO. PART NO. DESCRIPTION - QUOTE PRICE QTY EXTENDED PRICE
1 APT-0463 DocuSign Enterprise Pro Edition - Envelope Subs.
DocuSign, Inc. - APT-0463
Start Date: 10/23/2019
End Date: 10/22/2020
$3.90 OM 7500 $29,250.00
2 APT-0148 Enterprise Premier Support
DocuSign, Inc. - APT-0148
Start Date: 10/23/2019
End Date: 10/22/2020
$6,435.00 OM 1 $6,435.00
SUBTOTAL: $35,685.00
TOTAL PRICE: $35,685.00
TOTAL QUOTE: $35,685.00
Product Details
eSignature Envelope Allowance: 7,500
Overage/Usage Fees
DocuSign Enterprise Pro Edition - Envelope Subs. (Per Transaction): $8.80
Terms & Conditions
This Order Form covers the DocuSign Products and Services described herein and is governed by DocuSign's Corporate Subscriber Terms
and Conditions available online at: http://www.carahsoft.com/application/files/1214/7516/7222/DocuSign_CSA.pdf
CONFIDENTIAL QUOTE DATE: 10/23/2019
PAGE 1 of 1 QUOTE NO: 17414879
TO:
Susan Sullivan
CRM - Information Governance Administrator – BITS
Pitkin County Government
FROM:
Kimberly Barrera
DocuSignGovernment at Carahsoft
11493 Sunset Hills Road
530 E. Main St. Suite 100
Suite #203 Reston, Virginia 20190
Aspen, CO 81611 USA
EMAIL: susan.sullivan@pitkincounty.com EMAIL: Kimberly.Barrera@carahsoft.com
PHONE: (970) 920-5845 PHONE: (571) 662-3450 FAX: (703) 871-8505
TERMS:
FTIN: 52-2189693
QUOTE NO:
17414879
Shipping Point: FOB Destination QUOTE DATE: 10/23/2019
Remit To: Same as Above QUOTE EXPIRES: 10/23/2019 Payment Terms: Net 30 (On Approved Credit) RFQ NO:
DUNS No: 088365767 SHIPPING: ESD
Certificate Of Completion
Envelope Id: CD46DAB03F464E0CBDD5575F32117F7D Status: Completed
Subject: Carahsoft | Pitkin County Change Order 395.2016 D for Review and Signature
Source Envelope:
Document Pages: 5 Signatures: 3 Envelope Originator:
Certificate Pages: 5 Initials: 0 Pitkin County Procurement
AutoNav: Enabled
EnvelopeId Stamping: Disabled
Time Zone: (UTC-07:00) Mountain Time (US & Canada)
530 East Main Street
Suite 203
Aspen, CO 81611
Procurement@PitkinCounty.com
IP Address: 65.38.144.66
Record Tracking
Status: Original
10/28/2019 4:35:33 PM
Holder: Pitkin County Procurement
Procurement@PitkinCounty.com
Location: DocuSign
Susan Sullivan
Susan.Sullivan@PitkinCounty.com
IG Administrator
Pitkin County Colorado
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 65.38.144.66
Sent: 10/28/2019 4:41:27 PM
Viewed: 10/29/2019 9:02:36 AM
Signed: 10/29/2019 9:02:51 AM
Electronic Record and Signature Disclosure:
Accepted: 7/2/2019 9:08:21 AM
ID: bad90a98-3b18-4bd0-af59-041d01cca178
Company Name: Pitkin County, Colorado
Kimberly Barrera
kimberly.barrera@carahsoft.com
Renewal specialist
Security Level: Email, Account Authentication
(None) Signature Adoption: Pre-selected Style
Using IP Address: 38.135.93.12
Sent: 10/29/2019 9:02:56 AM
Viewed: 10/29/2019 9:04:05 AM
Signed: 10/29/2019 12:54:05 PM
Electronic Record and Signature Disclosure:
Accepted: 10/29/2019 9:04:05 AM
ID: 18e9fac1-d0e8-4862-8ce8-fbe519160996
Company Name: Pitkin County, Colorado
Jon Peacock
Jon.Peacock@PitkinCounty.com
County Manager
Pitkin County
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 6/12/2019 9:29:00 AM
ID: 917e30ed-8186-40bf-b2f9-0336f129484c
Company Name: Pitkin County, Colorado
Signature Adoption: Drawn on Device
Using IP Address: 75.71.107.170
Signed using mobile
Sent: 10/29/2019 12:54:07 PM
Resent: 11/5/2019 3:35:46 PM
Viewed: 11/9/2019 9:29:33 AM
Signed: 11/9/2019 9:29:48 AM
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Signer Events Signature Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Pitkin County Procurement
procurement@pitkincounty.com
Procurement
Pitkin County
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 6/21/2019 11:35:47 AM
ID: f4b0c7d5-e378-4bad-8806-08d16f6ff44c
Company Name: Pitkin County, Colorado
Accounts Payable
AP@pitkincounty.com
Accounts Payable
Pitkin County
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Sent: 11/9/2019 9:29:52 AM
Resent: 11/9/2019 9:30:00 AM
Viewed: 11/15/2019 10:22:23 AM
Sent: 11/9/2019 9:29:55 AM
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 11/9/2019 9:29:55 AM
Certified Delivered Security Checked 11/9/2019 9:29:55 AM
Signing Complete Security Checked 11/9/2019 9:29:55 AM
Completed Security Checked 11/9/2019 9:29:55 AM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
Intermediary Delivery Events Status Timestamp
Electronic Record and Signature Disclosure created on: 6/11/2019 12:14:06 PM
Parties agreed to: Susan Sullivan, Kimberly Barrera, Jon Peacock, Pitkin County Procurement
ELECTRONIC RECORD AND SIGNATURE DISCLOSURE
From time to time, Pitkin County (we, us or Pitkin County) may be required by law to provide to
you certain written notices or disclosures. Described below are the terms and conditions for
providing to you such notices and disclosures electronically when we send you documents for
electronic signature.
Acknowledging your Access, Intent, and Consent to Receive and Sign Materials
Electronically
To confirm that you can access this information electronically, which will be similar to other
electronic notices and disclosures that we will provide to you, please verify that you were able to
read this electronic disclosure and that you also were able to print on paper or electronically save
this page for your future reference and access or that you were able to e-mail this disclosure and
consent to an address where you will be able to print on paper or save it for your future reference
and access. Further, if you consent to receive notices and disclosures exclusively in electronic
format on the terms and conditions described above, please let us know by clicking the 'I agree'
button below.
By checking the 'I Agree' box, I confirm that:
I am establishing my intent to be bound to the transaction, and indicating that I am fully
aware of the purpose for which the signature is being provided.
I can access and read this Electronic CONSENT TO ELECTRONIC RECEIPT OF
ELECTRONIC RECORD AND SIGNATURE DISCLOSURES document; and
I can print on paper the disclosure or save or send the disclosure to a place where I can
print it, for for future reference and access; and
Until or unless I notify Pitkin County as described above, I consent to receive from
exclusively through electronic means all notices, disclosures, authorizations,
acknowledgements, and other documents that are required to be provided or made
available to me by Pitkin County during the course of my relationship with you.
Signing Documents without a Pitkin County DocuSign Account:
Pitkin County may not require all document signers to be authorized users of the Pitkin County
DocuSign Account. Please read the information below carefully and thoroughly, and if you can
access this information electronically to your satisfaction and agree to these terms and
conditions, please confirm your agreement by clicking the 'I agree' button at the bottom of this
document. When you don't have a DocuSign Account, you will be provided the opportunity to
agree to the Legal Disclosure each time you open an "envelope" for signing, at this time, you can
download and retain this disclosure. Pitkin County will forward completed documents that
you've reviewed, processed or signed via email. Should you require copies of these signed
documents (e.g., if they get deleted from your email account) you should request those
documents from Pitkin County under the Colorado Open Records Act by contacting the Pitkin
County custodian who sent you the document for signature.
Signing Documents with a Pitkin County DocuSign Account:
Please read the information below carefully and thoroughly, and if you can access this
information electronically to your satisfaction and agree to these terms and conditions, please
confirm your agreement by clicking the 'I agree' button at the bottom of this document.
Getting paper or electronic copies
At any time, you may request from us a paper or electronic copy of any record provided or made
available electronically to you by us. For such copies, as long as you are an authorized user of
the DocuSign system you will have the ability to download and print any documents we send to
you through your DocuSign user account for a limited period of time (usually 30 days) after such
documents are first sent to you. After such time, if you wish for us to send you paper or
electronic copies of any such documents from our office to you, you may be charged a per-page
fee. You may request delivery of such paper or electronic copies from us by following the
procedure described below.
Withdrawing your consent
If you are an authorized DocuSign Account holder, you can decide to receive notices and
disclosures from us electronically, you may at any time change your mind and tell us that
thereafter you want to receive required notices and disclosures only in paper format. Described
below is the process for informing us of your decision to receive future notices and disclosure in
paper format and also how to withdraw your consent to receive notices and disclosures
electronically.
Consequences of changing your mind
If you elect to receive required notices and disclosures only in paper format, it will slow the
speed at which we can complete certain steps in transactions with you and delivering services to
you because we will need first to send the required notices or disclosures to you in paper format,
and then wait until we receive back from you your acknowledgment of your receipt of such
paper notices or disclosures. To indicate to us that you are changing your mind, you must
withdraw your consent using the DocuSign 'Withdraw Consent' form on the signing page of your
DocuSign account. This will indicate to us that you have withdrawn your consent to receive
required notices and disclosures electronically from us and you will no longer be able to use your
DocuSign user account to receive required notices and consents electronically from us or to sign
electronically documents from us.
All notices and disclosures will be sent to you electronically
Unless you tell us otherwise in accordance with the procedures described herein, we will provide
electronically to you through your DocuSign user account all required notices, disclosures,
authorizations, acknowledgments, and other documents that are required to be provided or made
available to you during the course of our relationship with you. To reduce the chance of you
inadvertently not receiving any notice or disclosure, we prefer to provide all of the required
notices and disclosures to you by the same method and to the same address that you have given
us. Thus, you can receive all the disclosures and notices electronically or in paper format through
the paper mail delivery system. If you do not agree with this process, please let us know as
described below. Please also see the paragraph immediately above that describes the
consequences of your electing not to receive delivery of the notices and disclosures
electronically from us.
How to contact Pitkin County:
You may contact us to let us know of your changes as to how we may contact you electronically,
to request paper copies of certain information from us, and to withdraw your prior consent to
receive notices and disclosures electronically as follows:
To contact us by email send messages to: susan.sullivan@pitkincounty.com
To advise Pitkin County of your new e-mail address
To let us know of a change in your e-mail address where we should send notices and disclosures
electronically to you, you must send an email message to us at susan.sullivan@pitkincounty.com
and in the body of such request you must state: your previous e-mail address, your new e-mail
address .
In addition, you must notify DocuSign, Inc to arrange for your new email address to be reflected
in your DocuSign account by following the process for changing e-mail in DocuSign.
To request paper or electronic copies from Pitkin County
To request delivery from us of paper or electronic copies of the notices and disclosures
previously provided by us to you electronically, you should request those documents from Pitkin
County under the Colorado Open Records Act by contacting the Pitkin County custodian who
sent you the document for signature. .
To withdraw your consent with Pitkin County
To inform us that you no longer want to receive future notices and disclosures in electronic
format you may:
i. decline to sign a document from within your DocuSign account, and on the subsequent
page, select the check-box indicating you wish to withdraw your consent, or you may;
ii. send us an e-mail to susan.sullivan@pitkincounty.com and in the body of such request
you must state your e-mail, full name, Postal Address, telephone number, and account
number.
DocuSign Government at Carahsoft
11493 SUNSET HILLS ROAD |Suite 100 |Reston,Virginia 20190
Phone (703)871-8500 |Fax (703)871-8505 |Toll Free (888)662-2724
www.carahsoft.com |sales@carahsoft.com
Government -Price Quotation
PAGE 1 of 2
QUOTE DATE:
QUOTE NO:
07/22/2020
23173746CONFIDENTIAL
TO:Schuyler Clay
Business Process Analyst
Pitkin County
530 E.Main St
Aspen,CO 81611
schuyler.clay@pitkincounty.com
(970)429-6118
EMAIL:
PHONE:
FROM:Kimberly Barrera
DocuSignGovernment at Carahsoft
11493 Sunset Hills Road
Suite 100
Reston,Virginia 20190
EMAIL:Kimberly.Barrera@carahsoft.com
PHONE:(571)662-3450 FAX:(703)871-8505
TERMS:FTIN:52-2189693
Shipping Point:FOB Destination
Remit To:Same as Above
Payment Terms:Net 30 (On Approved Credit)
Cage Code:1P3C5
DUNS No:088365767
Credit Cards:VISA/MasterCard/AMEX
Sales Tax May Apply
QUOTE NO:23173746
$33,652.22TOTALQUOTE:
QUOTE DATE:07/22/2020
QUOTE EXPIRES:
RFQ NO:
SHIPPING:
TOTAL PRICE:
ESD
$33,652.22
08/13/2020
LINE NO.PART NO.DESCRIPTION -QUOTE PRICE QTY EXTENDED PRICE
APT-0463 DocuSign Enterprise Pro Edition -Envelope Subs.
DocuSign,Inc.-APT-0463
Start Date:08/11/2020
End Date:08/12/2021
$3.9017 7500 $29,262.751OM
APT-0075 Premier Support
DocuSign,Inc.-APT-0075
Start Date:08/11/2020
End Date:08/12/2021
$4,389.47 1 $4,389.472OM
$33,652.22SUBTOTAL:
TOTAL PRICE:
TOTAL QUOTE:$33,652.22
$33,652.22
Government -Price Quotation
LINE NO.PART NO.DESCRIPTION -QUOTE PRICE QTY EXTENDED PRICE
11493 SUNSET HILLS ROAD |Suite 100 |Reston,Virginia 20190
Phone (703)871-8500 |Fax (703)871-8505 |Toll Free (888)662-2724
www.carahsoft.com |sales@carahsoft.com
DocuSign Government at Carahsoft
PAGE 2 of 2
QUOTE DATE:
QUOTE NO:
07/22/2020
23173746CONFIDENTIAL
Product Details
eSignature Envelope Allowance:7,500
----------------------------------------
Overage/Usage Fees
DocuSign Enterprise Pro Edition -Envelope Subs.(Per Transaction):$9.26
--------------------------------------------
Order Special Terms:
Both parties hereby agree that:a)the Order Form with an Order Start Date of Oct 23,2019 (Quote 17414879 /Customer PO 395.2016 D)
will be terminated upon the Order Start Date of this Order Form,and b)a prorated credit for the prepaid portion of the remaining Term
of the terminated Order Form will be applied toward payment for this Order Form.
----------------------------------------
Terms &Conditions
This Order Form covers the DocuSign Products and Services described herein and is governed by DocuSign's Corporate Subscriber Terms
and Conditions available online at:http://www.carahsoft.com/application/files/1214/7516/7222/DocuSign_CSA.pdf
Certificate Of Completion
Envelope Id: 8B59ECFBC6284FCE840AE518CD42ED4C Status: Completed
Subject: Carahsoft | Pitkin County Change Order 395.2016 E for Review and Signature
Source Envelope:
Document Pages: 12 Signatures: 3 Envelope Originator:
Certificate Pages: 5 Initials: 0 Pitkin County Procurement
AutoNav: Enabled
EnvelopeId Stamping: Disabled
Time Zone: (UTC-07:00) Mountain Time (US & Canada)
530 East Main Street
Suite 203
Aspen, CO 81611
Procurement@PitkinCounty.com
IP Address: 107.77.196.117
Record Tracking
Status: Original
8/24/2020 3:11:55 PM
Holder: Pitkin County Procurement
Procurement@PitkinCounty.com
Location: DocuSign
Signer Events Signature Timestamp
Carrie Fleischman
Carrie.Fleischman@PitkinCounty.com
Interim IT Director
Pitkin County
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 65.38.144.66
Sent: 8/24/2020 3:22:54 PM
Viewed: 8/24/2020 3:23:17 PM
Signed: 8/24/2020 3:24:00 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Kimberly Barrera
kimberly.barrera@carahsoft.com
Renewal specialist
Carahsoft
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 38.135.93.12
Sent: 8/24/2020 3:25:01 PM
Viewed: 8/24/2020 3:26:32 PM
Signed: 8/24/2020 3:27:40 PM
Electronic Record and Signature Disclosure:
Accepted: 8/24/2020 3:26:32 PM
ID: 89adc9ee-c1c6-48aa-9cbc-55409f5c9359
Company Name: Pitkin County, Colorado
Rich Englehart
Rich.Englehart@PitkinCounty.com
Deputy County Manager
Pitkin County
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 174.198.160.196
Signed using mobile
Sent: 8/24/2020 3:27:43 PM
Resent: 8/31/2020 12:34:11 PM
Viewed: 8/31/2020 1:14:24 PM
Signed: 8/31/2020 1:14:54 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Carrington Taylor
carrington.taylor@docusign.com
HR Manager
Security Level: Email, Account Authentication
(None)
Sent: 8/24/2020 3:25:03 PM
Electronic Record and Signature Disclosure:
Accepted: 8/24/2020 3:24:30 PM
ID: aca0904f-4788-4e2a-add7-f13aada22702
Company Name: Pitkin County, Colorado
Pitkin County Procurement
procurement@pitkincounty.com
Procurement
Pitkin County
Security Level: Email, Account Authentication
(None)
Sent: 8/31/2020 1:14:57 PM
Resent: 8/31/2020 1:15:05 PM
Viewed: 8/31/2020 1:44:26 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Accounts Payable
AP@pitkincounty.com
Accounts Payable
Pitkin County
Security Level: Email, Account Authentication
(None)
Sent: 8/31/2020 1:15:00 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Jeanette Jones
Jeanette.jones@pitkincounty.com
BOCC Clerk
Pitkin County
Security Level: Email, Account Authentication
(None)
Sent: 8/31/2020 1:15:02 PM
Viewed: 8/31/2020 1:16:48 PM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 8/31/2020 1:15:02 PM
Certified Delivered Security Checked 8/31/2020 1:15:02 PM
Signing Complete Security Checked 8/31/2020 1:15:02 PM
Completed Security Checked 8/31/2020 1:15:02 PM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
ELECTRONIC RECORD AND SIGNATURE DISCLOSURE
From time to time, Pitkin County (we, us or Pitkin County) may be required by law to provide
you with certain written notices or disclosures. Described below are the terms and conditions for
providing to you such notices and disclosures electronically when we send you documents for
electronic signature.
Acknowledging your Access, Intent, and Consent to Receive and Sign Materials
Electronically
To confirm that you can access this information electronically, which will be similar to other
electronic notices and disclosures that we will provide to you, please verify that you were able to
read this electronic disclosure and that you also were able to print on paper or electronically save
this page for your future reference and access or that you were able to e-mail this disclosure and
consent to an address where you will be able to print on paper or save it for your future reference
and access. Further, if you consent to receive notices and disclosures exclusively in electronic
format on the terms and conditions described above, please let us know by clicking the 'I agree'
button below.
By checking the 'I Agree' box, I confirm that:
I am establishing my intent to be bound to the transaction, and indicating that I am fully
aware of the purpose for which the signature is being provided.
I can access and read this Electronic CONSENT TO ELECTRONIC RECEIPT OF
ELECTRONIC RECORD AND SIGNATURE DISCLOSURES document; and
I can print on paper the disclosure or save or send the disclosure to a place where I can
print it, for future reference and access; and
Until or unless I notify Pitkin County as described above, I consent to receive from
exclusively through electronic means all notices, disclosures, authorizations,
acknowledgments, and other documents that are required to be provided or made
available to me by Pitkin County during the course of my relationship with you.
Signing Documents without a Pitkin County DocuSign Account:
Pitkin County may not require all document signers to be authorized users of the Pitkin County
DocuSign Account. Please read the information below carefully and thoroughly, and if you can
access this information electronically to your satisfaction and agree to these terms and
conditions, please confirm your agreement by clicking the 'I agree' button at the bottom of this
document. When you don't have a DocuSign account, you will be provided the opportunity to
agree to the Legal Disclosure each time you open an "envelope" for signing, at this time, you can
download and retain this disclosure. Pitkin County will forward completed documents that
you've reviewed, processed or signed via email. Should you require copies of these signed
documents (e.g., if they get deleted from your email account) you should request those
documents from Pitkin County under the Colorado Open Records Act by contacting the Pitkin
County custodian who sent you the document for signature.
Signing Documents with a Pitkin County DocuSign Account:
Electronic Record and Signature Disclosure created on: 3/20/2020 3:28:13 PM
Parties agreed to: Kimberly Barrera, Carrington Taylor
Please read the information below carefully and thoroughly, and if you can access this
information electronically to your satisfaction and agree to these terms and conditions, please
confirm your agreement by clicking the 'I agree' button at the bottom of this document.
Getting paper or electronic copies
At any time, you may request from us a paper or electronic copy of any record provided or made
available electronically to you by us. For such copies, as long as you are an authorized user of
the DocuSign system you will have the ability to download and print any documents we send to
you through your DocuSign user account for a limited period of time (usually 30 days) after such
documents are first sent to you. After such time, if you wish for us to send you paper or
electronic copies of any such documents from our office to you, you may be charged a per-page
fee. You may request delivery of such paper or electronic copies from us by following the
procedure described below.
Withdrawing your consent
If you are an authorized DocuSign Account holder, you can decide to receive notices and
disclosures from us electronically, you may at any time change your mind and tell us that
thereafter you want to receive required notices and disclosures only in paper format. Described
below is the process for informing us of your decision to receive future notices and disclosure in
paper format and also how to withdraw your consent to receive notices and disclosures
electronically.
Consequences of changing your mind
If you elect to receive required notices and disclosures only in paper format, it will slow the
speed at which we can complete certain steps in transactions with you and delivering services to
you because we will need first to send the required notices or disclosures to you in paper format,
and then wait until we receive back from you your acknowledgment of your receipt of such
paper notices or disclosures. To indicate to us that you are changing your mind, you must
withdraw your consent using the DocuSign 'Withdraw Consent' form on the signing page of your
DocuSign account. This will indicate to us that you have withdrawn your consent to receive
required notices and disclosures electronically from us and you will no longer be able to use your
DocuSign user account to receive required notices and consents electronically from us or to sign
electronically documents from us.
All notices and disclosures will be sent to you electronically
Unless you tell us otherwise in accordance with the procedures described herein, we will provide
electronically to you through your DocuSign user account all required notices, disclosures,
authorizations, acknowledgments, and other documents that are required to be provided or made
available to you during the course of our relationship with you. To reduce the chance of you
inadvertently not receiving any notice or disclosure, we prefer to provide all of the required
notices and disclosures to you by the same method and to the same address that you have given
us. Thus, you can receive all the disclosures and notices electronically or in paper format through
the paper mail delivery system. If you do not agree with this process, please let us know as
described below. Please also see the paragraph immediately above that describes the
consequences of your electing not to receive delivery of the notices and disclosures
electronically from us.
How to contact Pitkin County:
You may contact us to let us know of your changes as to how we may contact you electronically,
to request paper copies of certain information from us, and to withdraw your prior consent to
receive notices and disclosures electronically as follows:
To contact us by email send messages to Helpdesk@provelocity.com
To advise Pitkin County of your new e-mail address
To let us know of a change in your e-mail address where we should send notices and disclosures
electronically to you, you must send an email message to us at Helpdesk@provelocity.com and
in the body of such request you must state: your previous e-mail address, your new e-mail
address .
In addition, you must notify DocuSign, Inc to arrange for your new email address to be reflected
in your DocuSign account by following the process for changing e-mail in DocuSign.
To request paper or electronic copies from Pitkin County
To request delivery from us of paper or electronic copies of the notices and disclosures
previously provided by us to you electronically, you should request those documents from Pitkin
County under the Colorado Open Records Act by contacting the Pitkin County custodian who
sent you the document for signature.
To withdraw your consent with Pitkin County
To inform us that you no longer want to receive future notices and disclosures in electronic
format you may:
i. decline to sign a document from within your DocuSign account, and on the subsequent
page, select the check-box indicating you wish to withdraw your consent, or you may;
ii. send us an e-mail to Helpdesk@provelocity.com and in the body of such a request, you
must state your e-mail, full name, Postal Address, telephone number, and account
number.