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HomeMy WebLinkAboutbocc.con.amended.179.18 L-4 2019-12-17 CDD 4VKIN Pitkin County Procurement Cover Sheet COUNT' @./D.C\ 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 179.18 L-4 Project Name February 2021 Parts Orders Contractor Wagner Equipment, Inc - GJ Budget Line Item By Individual Task Order $42253100.574000 $ 897.31 Additional Budget Line 42253100.563700 $ 1,357.29 Item(s) $ _ (Please fully allocate New Contract Total) — $ 2,254.60 Procurement Method: Formal Type: Goods, Equipment, Supplies Contract Start Date 2/1/2021 Contract End Date 3/17/2021 Contract Type Task Order Retainage No If this is a new contractor, please enter the New Vendor information into Munis for workflow approval. Contact Information: Department Fleet County Representative James Gilliam County Representative (970) 920-5765 Phone Provide a brief description of the contract: Parts purchases for February of 2021. Contract Value Summary: Original Contract Amount $ 2,254.60 Previous Change Order/Amendment Amount $This Change order/Amendment amount $New Contract Total $ 2,254.60 Master Service Agreement#: 179.18 Rev:2018-10-10 btf 41iTKIN COUNT TASK ORDER Task Order/Project Name: Jan 2021 Parts Orders Task Order Number: 179.18 L-4 Task Order Budget Line Item: 42253100.574000 ($897.31); 42253100.563700 ($1,357.29) OWNER: CONTRACTOR: Pitkin County Wagner Equipment, Inc - GJ James Gilliam—Fleet Tom Catt 76 Service Center Road 2322 I70 Frontage Road Aspen, CO 81611 Grand Junction, CO 81505 Phone: (970)920-5765 Phone: (970)245-6546 James.Gilliam@PitkinCounty.com Catt_Tom@WagrierEquipment.com PROJECT NAME: JAN 2021 PARTS ORDERS START DATE: February 1,2021 END DATE: March 17, 2021 The Caterpillar Parts and Service (the "Agreement") dated July 1, 2018 between the Board of County Commissioners of Pitkin County(the"County")and Wagner Equipment, Inc-GJ 2322 I70 Frontage Road Grand Junction, CO 81505 (the "Contractor"), shall include the following services. 1. Contractor's Obligations. Contractor shall provide the goods as described in the attached invoices, included as Attachment A. 2. Compensation and Expenses, Invoicing, Payment and Offset. The County shall compensate Contractor for its services in accordance with the Project Budget and Schedule set out in Paragraph 1 of this Task Order. It is expressly understood and agreed that in no event will the total compensation and reimbursement to be paid hereunder exceed the sum of Two-Thousand Two-Hundred Fifty-Four dollars and Sixty cents ($2,254.60) for all services rendered. By Task Order or Task Order Amendment, the County and Contractor may reallocate the budget among project tasks if the total budget amount remains unchanged. Contractor shall invoice for the project monthly based on hours worked, with payment expected within thirty (30) days of invoice, but any payment by the County may be offset by any amount the Contractor owes the County for any reason. Any invoices not sent in the following manner may have payment delayed. All invoices for this Task Order shall reference Task Order 179.18 L-4 and Jan 2021 Parts Orders. Invoices shall be sent electronically in PDF format to James.Gilliam@PitkinCounty.com. 1 Master Service Agreement#: 179.18 Rev:2018-10-10 btf 3. Pitkin County's Obligations. Pitkin County shall administer this contract through a County Representative. James Gilliam, Fleet Management will manage the project as the County's Representative. The services provided and products delivered by the Contractor under this contract will be subject to review by the County's Representatives, or a designee, for compliance with Contractor's obligations prior to final payment. 4. Formation of Task Order. This Task Order is issued in accordance with the provisions of the Agreement. Contractor agrees to provide services subject to the terms of this Task Order and for the avoidance of doubt this Task Order consists of the terms set out in the Agreement. In all other respects the Agreement is in full force and effect and remains unchanged by this Task Order. WAGNER EQUIPMENT, INC - GJ Card, G L,u/5 Mar-05-2021 Carol Galvez Date Customer account Representative PITKIN COUNTY,COLORADO ;417 04 4 ,e0, 0114"4.1 4 ' Mar-04-2021 James Gilliam Date Fleet Purchasing Specialist 2 0 NER CAS ; �gieri ehts ``c_T Rental STATEMENT ,r.. <� SI0S € Wagner Equipment Co. Customer Number: 69043 PO Box 919000 Denver,CO 80291-9000 Statement Date: 02/28/21 Balance -$14,909.96 INQUIRIES AND/OR QUESTIONS SHOULD BE DIRECTED TO: RP3 Carol Galvez AT: Galvez_Carol@wagnerequipment.com PITKIN CQUNTY FLEET MGMT 76 SERVICE CENTER RD ASPEN CO 81611-2567 Wagner Equipment Co.MAIN OFFICE:DENVER,CO(303)739-3133 Invoice Date Invoice Number Document Number Charges/Credits Balance Wagner Equipment 01/07/21 P00C2325930 AEC957084 1,530.11 1,530.11 01/07/21 P00C2325931 AEC957842 288.12 1,818.23 01/08/21 P00C2326394 AEC959033 14.56 1,832.79 01/08/21 S97W0031281 TP20425 6,228.00 8,060.79 01/09/21 P98C0158552 UUC062680 120.00 8,180.79 01/13/21 P98C0158570 UUC062697 149.31 8,330.10 01/14/21 P00C2328035 AEC962781 209.75 8,539.85 01/15/21 P00C2328449 AEC963457 421.80 8,961.65 01/19/21 P00C2329380 AEC965520 1,281.66 10,243.31 01/22/21 P00C2330466 AEC967676 565.32 10,808.63 01/23/21 P00C2330822 AEC967672 1,338.65 12,147.28 01/28/21 P00C2332129 AEC965520A �'J.eLf 4 , 89.92 15,320.18 02/09/21 P00C2335246 AEC976020 �C�j rv�' {w2��_9, (n0 1,089.92 16,410.10 02/11/21 P00C2336054 AEC978140 c� 02/17/21 P00C2337517 AEC981321 Lr�cl,5-,Stc 7 5 `'f e mC �1 /5�11' 3 f 187.92 16,598.02 268.54 16,866.56 02/24/21 POOC2339557 AEC984697 q 133.14 16,999.70 02/25/21 P00C2340007 AEC986226 92-)—(iNecr� 5 411)7&'6, 4 /3� 7��/ 575.08 17,574.78 Subtotal 17,574.78 ® Go Paperless. Receive statements and invoices online 24/7. Register at www.wagnerequipmert.com/gopaperless Total Due Continued Terms of Payment:All parts and services invoices are due the 10th day of month following the date of ,NC,Rt.IP ReAvoncy ills oia.* Nu i3or purchase or invoice date,All rental and sale invoices are due upon receipt.When you provide a check as payment,you authorize Us either to use information from your check to make a one-time electronic fund i �iN t '' �'°'1�" transfer from your account or to process the payment as a check transaction.Finance charge of 1.50%per RFMITTo: Wagner Equipment Co. month(annual percentage rate of 18%)will be charged on past due invoices. PO Box 919000 MONTHLY AGING OF UNPAID INVOICES PAYMENT RECEIVED AT END OF MONTH MAY NOT BE REFLECTED Denver, CO 80291-9000 Aurora,CO.18000 Smith Rd.,80011 Albuquerque,NM.4000 Osuna Rd.,NE,87109 303-739-3000*877-654-1237 www•wagnerequlpment.com 505-345-8411 *800-432-6612 i Burlington,CO Colo.Spgs.,CO Durango,CO Bloomfield,NM Grand Jct.,CO Hayden,CO Hobbs,NM Pueblo,CO Windsor,CO 1 719.346.7880 719-6350669 970-259.2001 505-634-4500 970-242-2834 970-276-3781 575-393-2148 719-544-4433 970-278.1750 844-378-7843 877-654.1237 877-654-1237 800-468-5081 877-654-1237 877.654-1237 800-821-6082 877-654-1237 877-654-1237 i PLEASE VISIT OUR WEBSITE CURRENT HOURS 1 OF OPERATION FOR ALL WAGNER EQUIPMENT T FOR CO AND WAGNERWAGN R RENTS/FACILITIES Page 1 of 2 Wagner Equipment Co.hires EEO/AA/Minorities/Women/Disabled Veterans 0,01 OWNER CST, INVOICE P.O.Box 17620 Denver,CO 80217-0620 INVOICE NUMBER: POOC2335246 Invoice Date: 02/09/21 DUE 03/10/21 $1089.92 Make AA Model 966M Serial# OKJP01157 Bill To: Equipment# Machine ID# Meter Reading Ship VIA UPS PITKIN COUNTY FLEET MGMT 76 SERVICE CENTER RD Ship To: ASPEN CO 81611-2567 OOUPS OOUPS JAMES GILLIAM 76 SERVICE CENTER RD. ASPEN Customer# PO# PSO/WO# PC LC MC INV.SEQ.NO. Doc Date Salesman Division i Store Terms 69043 01-049 AEC976020 10 10 8047437 02/04/21 JBB G 00 2 Quantity Item Description Unit Price Extension PARTS SALES PERSON: COMMERCE ORDER 1 270-9018 FILTER - AIR S 27 . 01 27 . 01 1 538-5051 ADAPTER GP S 897 .31 897 . 31 2 331-8108 ELEMENT AS S 37 . 18 74 . 36 3 463-2166 FILTER AS S 16. 55 49. 65 3 313-2458 FILTER-AIR S 4 . 86 14 . 58 1 270-9018 FILTER - AIR S 27 . 01 27 . 01 TOTAL PARTS DISCOUNT 35. 71- TOTAL PARTS 1089 . 92 T james .gilliam@pitkincounty.com TAX EXEMPTION LICENSE 98-02624 Sp t( r qa_07.5siee - Ps, 7. 3 / 4-[).-z c 51 e 0 " S Ce 7 coo 4 /4 as C.t REMIT TO: Wagner Equipment Co. If you're not completely satisfied please call 1-833-954-3116 or email us at customerexperience@wagnerequipment.com PO Box 919000 ��"4 Go Paperless. Receive statements and invoices online 24/7.Register at www.wagnerequipment.com/gopaperless Denver,CO 80291-9000 TOTAL Page 1 of 1 PLEASE PAY THIS AMOUNT $1089.92 WE APPRECIATE YOUR BUSINESS.Your business is important to us and we strive to be your dealership of choice.If we did not meet your expectations,please call 303.739.3000 Terms of Payment:Cash customer-Payment due on date of invoice.Total amount due the 10th day of month following invoice date.Finance charge of 1.50%per month (annual percentage rate of 18%)will be charged on past due invoices.When you provide a check as payment,you authorize us either to use information from your check to make a one-time electronic fund transfer from your account or to process the payment as a check transaction. Freight Terms:All parts purchased are f.o.b.source and incoming freight will be charged from source.Please refer to your parts sales order for the parts return policy details. Wagner Equipment Co.hires EEO/AA/Minorities/Women/Disabled Veterans Aurora,CO.18000 Smith Rd.,80011 www.wagnerequipment.com Albuquerque,NM.4000 Osuna Rd.,NE,87109 303.739-3000*877-654-1237 505-345-8411*800-432-6612 Burlington,CO Colo.Spgs.,CO Durango,CO Bloomfield,NM Grand Jct.,CO Hayden,CO Hobbs,NM Pueblo,CO Windsor,CO 719-346-7880 719-635-1669 970-259-2001 505-634-4500 970-242-2834 970-276-3781 575-393-2148 719-544.4433 970-278.1750 844-378-7843 877-654-1237 877-654-1237 800-468-5081 877-654-1237 877-654-1237 800-821-6082 877-654-1237 877-654-1237 Off WAGNER CAS` INVOICE P.O.Box 17620 Denver,CO 80217-0620 INVOICE NUMBER: POOC2336054 Invoice Date: 02/11/21 DUE 03/10/21 $187.92 Make AA Model 966M Serial# OKJP01157 Bill To: Equipment# Machine ID# Meter Reading Ship VIA UPS PITKIN COUNTY FLEET MGMT 76 SERVICE CENTER RD Ship To: ASPEN CO 81611-2567 OOUPS OOUPS JAMES GILLIAM 76 SERVICE CENTER RD. ASPEN Customer# PO# PSO/WO# PC LC MC INV.SEQ.NO. Doc Date Salesman Division Store Terms 69043 427 AEC978140 10 10 8053035 02/09/21 JBB G 00 2 Quantity Item Description Unit Price Extension PARTS SALES PERSON: COMMERCE ORDER 1 226-4755 *SEAL GP S 60 .25 60 .25 1 5P-4889 *SEAL S 17 . 37 17 . 37 1 228-4947 *SEAL-O-RING S 4 . 94 4 . 94 6 1R-0749 FILTER AS FU S 17 . 56 105. 36 TOTAL PARTS DISCOUNT 26.34- TOTAL PARTS 187 . 92 T james .gilliam@pitkincounty.com TAX EXEMPTION LICENSE 98-02624 REMIT TO: Wagner Equipment Co. If you're not completely satisfied please call 1-833-954-3116 or email us at customerexperience@wagnerequipment.com PO Box 919000 Go Paperless. Receive statements and invoices online 24/7.Register at www.wagnerequipment.com/gopaperless Denver,CO 80291-9000 TOTAL Page 1 of 1 PLEASE PAY THIS AMOUNT $187.92 WE APPRECIATE YOUR BUSINESS.Your business is important to us and we strive to be your dealership of choice.If we did not meet your expectations,please call 303.739.3000 Terms of Payment:Cash customer-Payment due on date of invoice.Total amount due the 10th day of month following invoice date.Finance charge of 1.50%per month (annual percentage rate of 18%)will be charged on past due invoices.When you provide a check as payment,you authorize us either to use information from your check to make a one-time electronic fund transfer from your account or to process the payment as a check transaction. Freight Terms:All parts purchased are f.o.b.source and incoming freight will be charged from source.Please refer to your parts sales order for the parts return policy details. I Wagner Equipment Co.hires EEO/AA/Minorities/Women/Disabled Veterans Aurora,CO.18000 Smith Rd.,80011 WWW.Wagnerequipment.Cont Albuquerque,NM.4000 Osuna Rd.,NE,87109 303-739.3000*877-654-1237 505-345-8411"800-432-6612 Burlington,CO Colo.Spgs.,CO Durango,CO Bloomfield,NM Grand Jct.,CO Hayden,CO Hobbs,NM Pueblo,CO Windsor,CO 719-346-7880 719-635-1669 970-259-2001 505-634.4500 970-242-2834 970-276-3781 575-393-2148 719-544-4433 970-278-1750 844-378-7843 877-654-1237 877-654-1237 800-468-5081 877-654-1237 877-654-1237 800-821-6082 877-654-1237 877-654-1237 010 1414 NER CAT INVOICE P.O.Box 17620 Denver,CO 80217-0620 INVOICE NUMBER: POOC2337517 Invoice Date: 02/17/21 DUE 03/10/21 $268.54 Make AA Model 966M Serial# OKJP01157 Bill To: Equipment# Machine ID# Meter Reading Ship VIA UPSRED PITKIN COUNTY FLEET MGMT 76 SERVICE CENTER RD Ship To: ASPEN CO 81611-2567 000PSRED OOUPSRED JAMES GILLIAM 76 SERVICE CENTER RD. ASPEN Customer# PO# PSO/WO# PC LC MC INV.SEQ.NO. Doc Date Salesman Division Store Terms 69043 451 AEC981321 10 10 8063124 02/15/21 JBB G 00 2 Quantity Item Description Unit Price Extension PARTS SALES PERSON: COMMERCE ORDER 1 381-3699 MOTOR GP-WIP S 268 .54 268 .54 TOTAL PARTS 268 .54 T james .gilliam@pitkincounty.com TAX EXEMPTION LICENSE 98-02624 REMIT TO: Wagner Equipment Co. if you're not completely satisfied please call 1-833-954-3116 or email us at customerexperiencef5wagnerequipment.com PO Box 919000 r. Go Paperless. Receive statements and invoices online 24/7.Register at www.wagnerequipment.com/gopaperless Denver,CO 80291-9000 TOTAL Page 1 of 1 PLEASE PAY THIS AMOUNT $268.54 WE APPRECIATE YOUR BUSINESS.Your business is important to us and we strive to be your dealership of choice.If we did not meet your expectations,please call 303.739.3000 Terms of Payment:Cash customer-Payment due on date of invoice.Total amount due the 10th day of month following invoice date.Finance charge of 1.50%per month (annual percentage rate of 18%)will be charged on past due invoices.When you provide a check as payment,you authorize us either to use information from your check to make a one-time electronic fund transfer from your account or to process the payment as a check transaction. Freight Terms:All parts purchased are f.o.b.source and incoming freight will be charged from source.Please refer to your parts sales order for the parts return policy details. Wagner Equipment Co.hires EEO/AA/Minorities/Women/Disabled Veterans Aurora,CO 18000 Smith Rd.,80011 pqnere WWW.WBg ul ment.com Albuquerque,NM.4000 Osuna Rd.,NE,87109 303-739-3000 877-654-1237 505-345.8411*800.432-6612 Burlington,CO Colo.Spgs.,CO Durango,CO Bloomfield,NM Grand Jct.,CO Hayden,CO Hobbs,NM Pueblo,CO Windsor,CO 719346-7880 719-635-1669 970-259-2001 505-634-4500 970-242-2834 970-276-3781 575-393-2148 719-544-4433 970-278-1750 844-378-7843 877-654-1237 877-654-1237 800-468-5081 877-654-1237 877-654-1237 800-821-6082 877-654-1237 877-654-1237 0,0 MAGNER AT INVOICE P.O.Box 17620 Denver,CO 80217-0620 INVOICE NUMBER: POOC2339557 Invoice Date: 02/24/21 DUE 03/10/21 $133.14 Make AA Model 966M Serial# OKJP01157 Bill To: Equipment# Machine ID# Meter Reading Ship VIA UPS PITKIN COUNTY FLEET MGMT 76 SERVICE CENTER RD Ship To: ASPEN CO 81611-2567 OOUPS OOUPS UPS Customer# PO# PSO/WO# PC LC MC INV.SEQ.NO. Doc Date salesman Division Store Terms 69043 262 AEC984697 10 10 8076314 02/22/21 KXA G 00 2 Quantity Item Description Unit Price Extension PARTS SALES PERSON: COMMERCE ORDER 1 603-1170 HUB AS N 133. 14 133. 14 TOTAL PARTS DISCOUNT 23. 50- TOTAL PARTS 133 . 14 T james .gilliam@pitkincounty.com ASPEN CO 81611-2567 TAX EXEMPTION LICENSE 98-02624 REMIT TO: Wagner Equipment Co. If you're not completely satisfied please call 1-833-954-3116 or email us at customerexperienceto7,wagnerequipment.com PO Box 919000 Go Paperless. Receive statements and invoices online 24/7.Register at www.wagnerequipment.com/gopaperless Denver,CO 80291-9000 TOTAL Page 1 of 1 PLEASE PAY THIS AMOUNT $133.14 WE APPRECIATE YOUR BUSINESS.Your business is important to us and we strive to be your dealership of choice.If we did not meet your expectations,please call 303.739.3000 Terms of Payment:Cash customer-Payment due on date of invoice.Total amount due the 10th day of month following invoice date.Finance charge of 1.50%per month (annual percentage rate of 18%)will be charged on past due invoices.When you provide a check as payment,you authorize us either to use information from your check to make a one-time electronic fund transfer from your account or to process the payment as a check transaction. Freight Terms:All parts purchased are f.o.b.source and incoming freight will be charged from source.Please refer to your parts sales order for the parts return policy details. Wagner Equipment Co.hires EEO/AA/Minorities/Women/Disabled Veterans Aurora,CO.18000 Smith Rd.,80011 www.wagnerequipment.com Albuquerque,NM.4000 Osuna Rd.,NE,87109 303-739-3000*877-654-1237 505-345-8411*800-432-6612 Burlington,CO Colo.Spgs.,CO Durango,CO Bloomfield,NM Grand Jct.,CO Hayden,CO Hobbs,NM Pueblo,CO Windsor,CO 719-346-7880 719-635-1669 970-259-2001 505-634-4500 970-242-2834 970-276-3781 575-393-2148 719-544-4433 970-278-1750 844-378-7843 877.654.1237 877-654-1237 800.468.5081 877-654-1237 877-654-1237 800-821-6082 877-654-1237 877-654-1237 O, MAGNER CAT, INVOICE P.O.Box 17620 Denver,CO 80217-0620 INVOICE NUMBER: POOC2340007 Invoice Date: 02/25/21 DUE 03/10/21 $575.08 Make AA Model 966M Serial# OKJP01157 Bill To: Equipment# Machine ID# Meter Reading Ship VIA UPS PITKIN COUNTY FLEET MGMT 76 SERVICE CENTER RD Ship To: ASPEN CO 81611-2567 OOUPS OOUPS JAMES GILLIAM 76 SERVICE CENTER RD. ASPEN Customer# PO# PSO/WO# PC LC MC INV.SEQ.NO. Doc Date Salesman Division Store Terms 69043 460 AEC986226 10 10 8079064 02/23/21 JBB G 00 2 Quantity Item Description Unit Price Extension PARTS SALES PERSON: COMMERCE ORDER 4 314-9984 WASHER INJ S 7 . 19 28 . 76 4 315-2352 NOZZLE AS . N 136. 58 546. 32 TOTAL PARTS 575 . 08 T james .gilliam@pitkincounty.com TAX EXEMPTION LICENSE 98-02624 REMIT TO: Wagner Equipment Co. If you're not completely satisfied please call 1-833-954-3116 or email us at customerexperience@wagnerequipment.com PO Box 919000 r. Go Paperless. Receive statements and invoices online 24/7.Register at www.wagnerequipment,comlgopaperless Denver,CO 80291-9000 TOTAL Page 1 of 1 PLEASE PAY THIS AMOUNT $575.08 WE APPRECIATE YOUR BUSINESS.Your business is important to us and we strive to be your dealership of choice.If we did not meet your expectations,please call 303.739.3000 Terms of Payment:Cash customer-Payment due on date of invoice.Total amount due the 10th day of month following invoice date.Finance charge of 1.50%per month (annual percentage rate of 18%)will be charged on past due invoices.When you provide a check as payment,you authorize us either to use information from your check to make a one-time electronic fund transfer from your account or to process the payment as a check transaction. Freight Terms:All parts purchased are f.o.b.source and incoming freight will be charged from source.Please refer to your parts sales order for the parts return policy details. Wagner Equipment Co.hires EEO/AA/Minorities/Women/Disabled Veterans Aurora,CO.18000 Smith Rd 80011 www-wagnerequipment.com Albuquerque,NM.4000 Osuna Rd.,NE,87109 303.739-3000*877.654.1237 505.345-8411*800.432-6612 Burlington,CO Colo.Spgs,CO Durango,CO Bloomfield,NM Grand Jct.,CO Hayden,CO Hobbs,NM Pueblo,CO Windsor,CO 1 719-346-7880 719-635-1669 970-259-2001 505-634-4500 970-242-2834 970-276-3781 575-393-2148 719-544-4433 970-278-1750 844-378-7843 877-654-1237 877-654-1237 800-468-5081 877-654-1237 877-654-1237 800-821-6082 877-654-1237 877-654-1237 DocuSign Certificate Of Completion Envelope Id: DA9F8C363001484999B9859C340886D3 Status:Completed Subject:Wagner I Pitkin County Parts Task Order 179.18 L-4 for Review and Signature Source Envelope: Document Pages:9 Signatures:2 Envelope Originator: Certificate Pages:5 Initials:0 Pitkin County Procurement AutoNav: Enabled 530 East Main Street Envelopeld Stamping: Disabled Suite 203 Time Zone: (UTC-07:00)Mountain Time(US&Canada) Aspen,CO 81611 Procurement@PitkinCounty.com IP Address: 107.77.199.220 Record Tracking Status:Original Holder:Pitkin County Procurement Location: DocuSign 3/4/2021 11:07:20 AM Procurement@PitkinCounty.com Signer Events Signature Timestamp James Gilliam Sent:3/4/2021 11:16:42 AM james.gilliam@pitkincounty.com 91.14 "` Viewed:3/4/2021 1:17:05 PM Fleet Purchasing Specialist Signed:3/4/2021 1:17:20 PM Pitkin County Security Level: Email,Account Authentication Signature Adoption: Pre selected Style (None) Using IP Address:65.38.144.66 Electronic Record and Signature Disclosure: Not Offered via DocuSign Carol Galvez Sent:3/4/2021 1:17:22 PM Galvez_Carol@wagnerequipment.com Card, AGokti5 Viewed:3/4/2021 1:49:51 PM Customer Account Representative Signed:3/5/2021 9:22:13 AM Security Level: Email,Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address:73.34.167.148 Electronic Record and Signature Disclosure: Accepted:6/4/2021 7:49:49 AM ID:0e3ef1 ce-1 fb3-4b06-99be-402b85039239 Company Name:Pitkin County,Colorado 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 Pitkin County Procurement COPIED Sent:3/5/2021 9:22:18 AM procurement@pitkincounty.com Resent:3/5/2021 9:22:24 AM Procurement Viewed:6/23/2021 8:33:52 AM Pitkin County Security Level: Email,Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Carbon Copy Events Status Timestamp Accounts Payable COPIED Sent:3/5/2021 9:22:19 AM AP@pitkincounty.com Viewed:3/5/2021 9:37:46 AM Accounts Payable Pitkin County Security Level: Email,Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Romany Iacono COPIED Sent:3/5/2021 9:22:22 AM romany.iacono@pitkincounty.com SSA Pitkin County Security Level: Email,Account Authentication (None) 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 3/4/2021 11:16:42 AM Certified Delivered Security Checked 3/4/2021 1:49:51 PM Signing Complete Security Checked 3/5/2021 9:22:13 AM Completed Security Checked 3/5/2021 9:22:22 AM Payment Events Status Timestamps Electronic Record and Signature Disclosure Electronic Record and Signature Disclosure created on:3/20/2020 3:28:13 PM Parties agreed to:Carol Galvez 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. 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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 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.