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HomeMy WebLinkAboutbocc.con.076.21 p T K I N Pitkin County Procurement Cover Sheet COUNT - fin,n7 — s 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 076.21 Project Name Cot Purchase for Coroner's Office Contractor Ferno Budget Line Item 15018100.574000 $ $Additional Budget Line $ Item(s) $ _ (Please fully allocate New Contract Total) $ Procurement Method: Sole Source Type: Goods, Equipment, Supplies Contract Start Date 4/1/2021 Contract End Date 7/31/2021 Contract Type New Contract Retainage Select from drop-down menu If this is a new contractor,please enter the New Vendor information into Munis for workflow approval. Contact Information: Department Coroner's Office County Representative County Representative Dr. J. Stevens Ayers phone (970) 618-3313 Provide a brief description of the contract: Purchase of new hydraulic cot including shipping cost. Delivery date TBD. Goods purchase of less than $50,000 - Sales Order/Invoice acts in place of templated Contract. Contract Value Summary: Original Contract Amount $ 38,610.75 Previous Change Order/Amendment Amount $This Change order/Amendment amount $New Contract Total $ 38,610.75 Rev 2018-10-10 btf PITKIN COUNTY SOLE SOURCE PROCUREMENT JUSTIFICATION REQUEST TO: Jon Peacock, County Manager DATE: April 5, 2021 FROM: Dr. J. Stevens Ayers, Chief Coroner/Medical Examiner Proposed Contractor: Ferno Product/Service: Hydraulic Patient Loading Cot Estimate expenditure for the above Product/Service: $ 38,610.75 This form is required, and is to aid you, in documenting your Sole Source request. Complete all portions of this form. This purchase is clearly and legitimately limited to a Single or Sole Source. (Examples: original manufacturer, no regional distributor, standardization etc): Explain: There are only two hydraulic patient(body) loading cots available in the US with installation, maintenance, and repair support available; Ferno and Stryker. The Stryker product is nearly twice as expensive so would not be justified in the expenditure and do not meet our functional needs. The Stryker cot hydraulic lift function is mostly based on a piece of equipment that is installed in an ambulance to assit with loading and unloading,while the cot itself only goes up and down. The Ferno cot has hydraulic function built into the legs of the cot, so it is able to function independently, allowing the user to maneuver the cot freely and navigate around obstacles when transferring a body. This functionality also makes the Ferno cot usable with most vehicles and would not require additional equipment to be installed for use. Ferno is a nationwide/worldwide distributor of its own equipment and purchases are made through their local offices, providing local and national support. The Ferno cot represents a financial and service value that could not be realized by purchasing through a different vendor. Note: Every effort should be made to obtain a written contract when otherwise required under County procedures. When a contract is obtained, complete the Clerk's check list and send the original signed contract with coversheet to clerk's office for archiving. 1 Rev 2018-10-10 btf The undersigned requests that Pitkin County waive other procurement requirements and recognize this transaction as a sole source exception to the Pitkin County Procurement Code. Department Head Section Head Vr. J. SI &u,ts QtjWS Apr-05-2021 Dr. J. Stevens Ayers Date Date Coroner County Manager Reason for Denial: Apr-06-2021 Jon Peacock Date County Manager Note: Every effort should be made to obtain a written contract when otherwise required under County procedures. When a contract is obtained, complete the Clerk's check list and send the original signed contract with coversheet to clerk's office for archiving. 2 0 FERN°. 877.733.0911 www.Ferno.com Quote Prepared For Our Valued Customer: Pitkin County Coroner Account ID: Quote#: 10708 Customer Contact: Billing Address: Shipping Address: Pitkin County Coroner Pitkin County Coroner 506 E Main Street 506 E Main Street Aspen, CO Aspen, Colorado 81611 81611 Terms: Valid Until:Apr 30, 2021 Freight Quote#: Carrier: TBD FOB Origin: Origin Your Sales Representative is: Your Customer Service Contact is: Aaron Davis Karen Boler a.davis@ferno.com k.boler@ferno.com (303) 880-2011 (877) 733-0911 Quantity Item # Product Customer Price 1 0000INXINLI INX INLINE W/DWL SHIP KIT INX INLINE W/DWL SHIP KIT $32,129.24 NDWL 1 0822480 INX BATTERY 30% CHARGE INX BATTERY 30% CHARGE $501.00 1 ILFS86UFPD INLINE 86 W/UFP MOUNT DC Fastener with Floor Plate and Charging. $5,650.51 C Hard Copy PO Required? Yes x No Dr. J. Stevens Ayers Vr. ,), Sl tt-ws Q urs Approval: Subtotal: $38,280.75 Apr-05-2021 Printed Name Signature Sales Tax: $0.00 Credit Card:AP will issue check upon signature Secure Code: Exp: Shipping Quote: $330.00 Comments: Install is separate and runs around Your Price: $38,610.75 1500.00 dollars Order subject to credit approval by Ferno.If not quoted,shipping and any applicable sales tax will be added to invoice.Credit cannot be allowed on returns of special or modified items.Prices and specifications are subject to change without notice. 70 Weil Way/Wilmington,Ohio 45177/info@ferno.com/888.388.1349 FAX DocuSign Certificate Of Completion Envelope Id: 1F32890E0ACD40219379459E74E16F77 Status:Completed Subject: Ferno I Pitkin County Contract XXX.19 for Review and Signature Source Envelope: Document Pages:4 Signatures:3 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: 107.77.197.160 Record Tracking Status:Original Holder:Pitkin County Procurement Location: DocuSign 4/5/2021 1:03:09 PM Procurement@PitkinCounty.com Signer Events Signature Timestamp Dr.J.Stevens Ayers Sent:4/5/2021 1:06:43 PM epiccorp@sopris.net Pr. j. StuAttA,S QL1t,Vs Viewed:4/5/2021 1:58:10 PM Coroner Signed:4/5/2021 2:00:16 PM Security Level: Email,Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address:73.78.25.2 Electronic Record and Signature Disclosure: Accepted:4/5/2021 1:58:10 PM ID: 14c34807-be01-40a2-85d0-abb2759f95e5 Company Name:Pitkin County,Colorado Jon Peacock Sent:4/5/2021 2:00:20 PM Jon.Peacock@PitkinCounty.com Viewed:4/6/2021 3:39:17 PM County Manager Signed:4/6/2021 3:39:47 PM Pitkin County Security Level: Email,Account Authentication Signature Adoption: Drawn on Device (None) Using IP Address:65.38.144.66 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 Pitkin County Procurement COPIED Sent:4/6/2021 3:39:50 PM procurement@pitkincounty.com Resent:4/6/2021 3:39:58 PM Procurement Viewed:6/24/2021 9:25:17 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:4/6/2021 3:39:51 PM AP@pitkincounty.com Accounts Payable Pitkin County Security Level: Email,Account Authentication (None) Electronic Record and Signature Disclosure: Not Offered via DocuSign Aaron Davis COPIED Sent:4/6/2021 3:39:53 PM a.davis@ferno.com 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 4/5/2021 1:06:43 PM Certified Delivered Security Checked 4/6/2021 3:39:17 PM Signing Complete Security Checked 4/6/2021 3:39:47 PM Completed Security Checked 4/6/2021 3:39:53 PM 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:Dr.J.Stevens Ayers 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. 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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 . 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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.