HomeMy WebLinkAboutbocc.con.amended.111.20 C 2019-12-17 CDD
411T K I N Pitkin County
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Contract Information
Contract Number 111.20 C
Project Name Runway and Taxiway Pavement Maintenance
Contractor American Road Maintenance
Budget Line Item 40451510.544530 $
$Additional Budget Line $
Item(s) $ _
(Please fully allocate New Contract Total)
Procurement Method: _Formal
Type: Construction
Contract Start Date 11/1/2020
Contract End Date 11/15/2021
Contract Type _Change Order
Retainage Yes - 5%
If this is a new contractor, please enter the New Vendor information into Munis for workflow approval.
Contact Information:
Department Airport
County Representative Dan Bartholomew County Representative (970)429-2851
Phone
Provide a brief description of the contract:
Change order for project closeout for material/quantity changes as attached. Extension through 11/15/21 for
processing. Project complete and accepted prior to 10/31/2021 original expiration date.
Contract Value Summary:
Original Contract Amount $ 1,685,929.00
Previous Change Order/Amendment Amount $ 240,759.00
This Change order/Amendment amount $ 13,364.74
New Contract Total $ 1,940,052.74
U.S. DEPARTMENT OF TRANSPORTATION
FEDERAL AVIATION ADMINISTRATION
AIRPORT IMPROVEMENT PROGRAM
CONTRACT CHANGE ORDER NO.: 3 or SUPPLEMENTAL AGREEMENT NO.: -
AIRPORT: Aspen-Pitkin County Airport DATE: October 8,2021
LOCATION: Aspen,CO AIP PROJECT NO.: 3-08-0003-056
CONTRACTOR: American Road Maintenance Project: RWY and TWY Pavement Maint.
You are requested to perform the following described work upon receipt of an approved copy of this document or as directed by the Engineer:
Unit Price/Unit
Item No. Description Unit Price Change Quantity Change [Final Quantity] CCO3 Total Amount
Schedule 1
P-101-5.2 Localized Partial Depth Milling for Asphalt Surface Patching(3" Depth) SY $ 18.00 -1.00 2,365.00
$ (18.00)
P-101-5.4 High Pressure Water Removal of White Runway Pavement Marking SF $ 1.50 753.00 150,953.00
$ 1,129.50
P-403-5.1 Asphalt Mix for Surface Patching TON $ 425.00 63.00 463.00
$ 26,775.00
P-603-5.1 Emulsified Asphalt Tack Coat GAL $ 6.00 15.00 405.00 $ 90.00
Total Schedule 1 $ 27,976.50
Schedule 2
P-620-5.1 Tempoary Pavement Marking SF $ 0.85 -15,104.00 16,996.00 $ (12,838.40)
Total Schedule 2 $ (12,838.40)
Schedule 3
P-101-5.2 Localized Partial Depth Milling for Asphalt Surface Patching(3") SY $ 18.00 37.11 127.11 $ 668.00
P-101-5.2-CORR* Localized Partial Depth Milling for Asphalt Surface Patching(3") SY $ 8.00 -88.00 -88.00 $ (704.00)
P-403-5.1 Asphalt Mix for Asphalt Surface Patching SF $ 425.00 -1.00 14.00
$ (425.00)
P-620-5.5 Permanent Pavement Markings without Beads SF $ 0.85 -1,543.95 5,026.05 $ (1,312.36)
Total Schedule 3 $ (1,773.36)
This Change Order Total $ 13,364.74
Previous Change Order(s)Total $ 240,759.00
Original Contract Total(Schedules 1,2 and 3) $ 1,685,929.00
Revised Contract Total $ 1,940,052.74
The time provided for completeion of the contract is not revised for these changes.
Recommended by: e 10/8/2021
Kimley-Horn and Associates, Inc. Date
Concurred by: 'tat Akilit " Nov-23-2021
Construction Projects Manager-FAA Date
Accepted by: I 0-ZS-Z
Ame can R ad Maintenance Date
Approved by: Do,,,, Q4.6noko4Au,, Nov-04-2021
Dan Bartholomew Datel
Airport Director
flAd Nov-04-2021
Rich Englehart Date
Deputy County Manager
AIP PROJECT NO.: 3-08-0003-056 CHANGE ORDER NO.: 3
AIRPORT: Aspen-Pitkin County Airport LOCATION: Aspen,CO
JUSTIFICATION FOR CHANGE
1. Brief description of the proposed contract change(s)and location(s).
Due to inclement weather and poor construction conditions(moisture),a second mobilization was required to
complete this project on 8/4/21 through 8/6/21.The second mobilization is accounted for in this CCO3 which includes
pavement marking removal and additional temporary and permanent pavement marking along TW A.Additionally,
this change order balances any excess or deficient line items.
The crack seal crew was also mobilized to address outstanding work along the northern part of RW 15-33,the North
GA Apron,and the Deicing Pad.This quantity was paid for in Pay Application 2 and 3 and is not configured into this
Change Order.
CCO3 pavement marking operations was focused on TW A and the connectors Al-A9.
2. Reason(s)for the change(s). (Continue on reverse if necessary.)
Poor construction conditions and moisture resulted in failing pavement marking during the first mobilization.Thus, Hi-
Lite(pavement marking sub-contractor)was required to mobilize a second time to finish any outstanding work along
TW A and the TW Connectors.
3. Justifications for unit cost or price.
The unit costs were maintained from CCO2 and the original contract.
4. The sponsor's share of this cost is available from:
Airport Capital Funds
5. If this is a supplemental agreement involving more than $2,000, is the cost estimate based on the latest wage rate
decision: Yes No❑ Not Applicable X
6. Has consent of surety been obtained? Yes ❑ Not Necessary X.
7. Will this change affect the insurance coverage? Yes❑ No X.
8. If yes,will the policies be extended? Yes ❑ No ❑.
9. Has this Change Order been discussed with FAA Officials?
Yes X No ❑ When:September 27, 2021 With Whom: Jesse Lyman
Comments
PERIODIC PAY APPLICATION Ki m l e >>> H o r n
ASPEN/PITKIN COUNTY AIRPORT -- ASPEN,COLORADO
RUNWAY AND TAXIWAY PAVEMENT MAINTENANCE
Expect More. Experience Better.
ASPEN/PITKIN COUNTY AIRPORT AIP PROJECT NO.. 3-08-0003-056 -
SPONSOR NAME:
Board of County Commissioners of Pitkin County,Colorado
KHA PROJECT NO.: 96557016
CONTRACTOR'S NAME AND ADDRESS: ASE CONTRACT NO.: NA
American Road Maintenance PAY APPLICATION NUMBER: 3
4554 E Eco Industrial Place PERIOD ENDING: 9/30/2021
Tucson,AZ 85756 %COMPLETE: 100.00%
BID ADDENDUM NO.2 CONTRACT CHANGE ORDER SUMMARY REVISED QUANTITIES TOTAL THIS PERIOD PREVIOUS TOTAL TOTAL TO DATE
Item No. Description Quantity Units Unit Cost Total Cost CO Quantity Unit Cost Total Cost Quantity Unit Cost Total Cost Quantity Total Cost Quantity Total Cost Quantity Total Cost %
SCHEDULE 1
C-105-6.1 Mobilization 1 LS $150,000.00 $150,000.00 $0.00 1 $150,000.00 $150,000.00 0 $0.00 1 $150,000.00 1 $150,000.00 100.00%
P-101-5.1 Partial Depth Saw Cut(3"Depth) 6600 LF $3.60 $23,760.00 2 (6,600) $3.60 ($23,760.00) 0 $3.60 $0.00 0 $0.00 0 $0.00 0 $0.00 0.00%
*P-101-5.2 Localized Partial Depth Milling for Asphalt Surface Patching(3"Depth) 1500 SY $20.00 $30,000.00 2 1,500 -$2.00 ($3,000.00) 1,500 $18.00 $27,000.00 0 $0.00 1,500 $27,000.00 1,500 $27,000.00 100.00%
*P-101-5.2 Localized Partial Depth Milling for Asphalt Surface Patching(3"Depth) 0 SY $0.00 $0.00 2/3 2,365 $18.00 $42,570.00 2,365 $18.00 $42,570.00 0 $0.00 2,365 $42,570.00 2,365 $42,570.00 100.00%
P-101-5.3 High Pressure Water Removal of Rubber 81600 SF $0.50 $40,800.00 $0.00 81,600 $0.50 $40,800.00 0 $0.00 81,600 $40,800.00 81,600 $40,800.00 100.00%
P-101-5.4 High Pressure Water Removal of White Runway Pavement Marking 150200 SF $1.50 $225,300.00 3 753 $1.50 $1,129.50 150,953 $1.50 $226,429.50 0 $0.00 150,953 $226,429.50 150,953 $226,429.50 100.00%
P-103-6.1 Survey, Layout,and Staking 1 LS $25,000.00 $25,000.00 $0.00 1 $25,000.00 $25,000.00 0 $0.00 1 $25,000.00 1 $25,000.00 100.00%
*P-403-5.1 Asphalt Mix for Asphalt Surface Patching 260 TON $450.00 $117,000.00 2 260 -$25.00 ($6,500.00) 260 $425.00 $110,500.00 0 $0.00 260 $110,500.00 260 $110,500.00 100.00%
*P-403-5.1 Asphalt Mix for Asphalt Surface Patching 0 TON $0.00 $0.00 2/3 463 $425.00 $196,775.00 463 $425.00 $196,775.00 0 $0.00 463 $196,775.00 463 $196,775.00 100.00%
P-603-5.1 Emulsified Asphalt Tack Coat 220 GAL $6.00 $1,320.00 2/3 185 $6.00 $1,110.00 405 $6.00 $2,430.00 0 $0.00 405 $2,430.00 405 $2,430.00 100.00%
CCO1-P-605-5.1 Crack Seal(1/8"to 1/2"Width) 0 TON $0.00 $0.00 1 3 $5,000.00 $15,000.00 3 $5,000.00 $15,000.00 0 $0.00 3 $15,000.00 3 $15,000.00 100.00%
CCO2-P-605-5.2 Crack Seal(1/2"to 1-1/4"Width) 0 TON $0.00 $0.00 1 1 $10,000.00 $10,000.00 1 $10,000.00 $10,000.00 0 $0.00 1 $10,000.00 1 $10,000.00 100.00%
P-608R-8.1 Asphalt Surface Treatment with Sand 94900 SY $3.50 $332,150.00 $0.00 94,900 $3.50 $332,150.00 0 $0.00 94,900 $332,150.00 94,900 $332,150.00 100.00%
P-608R-8.2 Asphalt Surface Treatment without Sand 81600 SY $2.50 $204,000.00 $0.00 81,600 $2.50 $204,000.00 0 $0.00 81,600 $204,000.00 81,600 $204,000.00 100.00%
P-608R-8.3 Runway and High Speed Exist Taxiway Friction Testing 1 LS $10,000.00 $10,000.00 $0.00 1 $10,000.00 $10,000.00 0 $0.00 1 $10,000.00 1 $10,000.00 100.00%
P-620-5.1 Temporary Pavement Marking 65200 SF $0.85 $55,420.00 1 67,880 $0.85 $57,698.00 133,080 $0.85 $113,118.00 0 $0.00 133,080 $113,118.00 133,080 $113,118.00 100.00%
P-620-5.2 Temporary Striated Pavement Markings 78050 SF $0.85 $66,342.50 1 (78,050) $0.85 ($66,342.50) 0 $0.00 $0.00 0 $0.00 0 $0.00 0 $0.00 0.00%
P-620-5.3 Permanent Pavement Markings with Beads 46320 SF $1.35 $62,532.00 1 86,320 $1.35 $116,532.00 132,640 $1.35 $179,064.00 0 $0.00 132,640 $179,064.00 132,640 $179,064.00 100.00%
P-620-5.4 Permanent Striated Pavement Markings with Beads 78050 SF $1.35 $105,367.50 1 (78,050) $1.35 ($105,367.50) 0 $1.35 $0.00 0 $0.00 0 $0.00 0 $0.00 0.00% II
P-620-5.5 Permanent Pavement Markings without Beads 24290 SF $1.35 $32,791.50 1 (16,120) $1.35 ($21,762.00) 8,170 $1.35 $11,029.50 0 $0.00 8,170 $11,029.50 8,170 $11,029.50 100.00%
P-620-5.6 Reflectivity Readings 1 LS $11,000.00 $11,000.00 $0.00 1 $11,000.00 $11,000.00 0.00 $0.00 1 $11,000.00 1 $11,000.00 100.00%
'TOTAL SCHEDULE 1 $1,492,783.50 $214,082.50 $1,706,866.00 $0.00 $1,706,866.00 $1,706,866.00 100.00%
* (See notes at the bottom of sheet 2)
'SCHEDULE2
C-105-6.1 Mobilization 1 LS $20,000.00 $20,000.00 $0.00 1 $20,000.00 $20,000.00 0 $0.00 1 $20,000.00 1 $20,000.00 100.00%
CCO1-P-605-5.1 Crack Seal(1/8"to 1/2"Width) 0 TON $0.00 $0.00 1 2 $5,000.00 $10,000.00 2 $5,000.00 $10,000.00 0 $0.00 2 $10,000.00 2 $10,000.00 100.00%
CCO2-P-605-5.2 Crack Seal(1/2"to 1-1/4"Width) 0 TON $0.00 $0.00 1 2 $10,000.00 $20,000.00 2 $10,000.00 $20,000.00 i 0 $0.00 2 $20,000.00 2 $20,000.00 100.00%
P-608R-8.2 Asphalt Surface Treatment without Sand 48340 SY $2.50 $120,850.00 $0.00 48,340 $2.50 $120,850.00 0 $0.00 48,340 $120,850.00 48,340 $120,850.00 100.00%
P-620-5.1 Temporary Pavement Marking 18370 SF $0.85 $15,614.50 1/3 (1,374) $0.85 ($1,167.90) 16,996 $0.85 $14,446.60 16,996 $14,446.60 0 $0.00 16,996 $14,446.60 100.00%
P-620-5.3 Permanent Pavement Marking with Beads 3940 SF $1.35 $5,319.00 1 10,870 $1.35 $14,674.50 14,810 $1.35 $19,993.50 14,810 $19,993.50 0 $0.00 14,810 $19,993.50 100.00%
P-620-5.5 Permanent Pavement Marking without Beads 29150 SF $0.85 $24,777.50 1 (11,460) $0.85 ($9,741.00) 17,690 $0.85 $15,036.50 982 $834.70 16,708 $14,201.80 17,690 $15,036.50 100.00%
TOTAL SCHEDULE 2 $186,561.00 $33,765.60 $220,326.601 $35,274.80 $185,051.80 $220,326.60 100.00%
SCHEDULE 3
C-105-6.1 Mobilization 1 LS $1,000.00 $1,000.00 $0.00 1.00 $1,000.00 $1,000.00 0 $0.00 1.00 $1,000.00 1.00 $1,000.00 100.00%
P-101-5.2 Localized Partial Depth Milling for Asphalt Surface Patching(3"Depth) 0 SY $0.00 $0.00 2/3 127.11 $18.00 $2,288.00 127.11 $18.00 $2,288.00 0 $0.00 127.11 $3,304.86 127.11 $2,288.00 100.00%
P-403-5.1 Asphalt Mix for Asphalt Surface Patching 0 TON $0.00 $0.00 2/3 14.00 $425.00 $5,950.00 14.00 $425.00 $5,950.00 0 $0.00 14.00 $5,950.00 14.00 $5,950.00 100.00%
P-603-5.1 Emulsified Asphalt Tack Coat 0 GAL $0.00 $0.00 2 9.00 $6.00 $54.00 9.00 $6.00 $54.00 9 $54.00 0.00 $0.00 9.00 $54.00 100.00%
P-620-5.5 Permanent Pavement Markings without Beads 6570 SF $0.85 $5,584.50 3 (1,543.95) $0.85 ($1,312.36) 5,026.05 $0.85 $4,272.14 0.00 I $0.00 5,026.05 $4,272.14 5,026.05 $4,272.14 100.00%
SUBTOTAL SCHEDULE 3 $6,584.50 $6,979.64 $13,564.14 $54.00 $14,527.00 $13,564.14 100.00%
*P-101-5.2-CORR. Localized Partial Depth Milling for Asphalt Surface Patching(3"Depth) 0 SY $0.00 $0.00 0 0 $0.00 $0.00 -88 $8.00 -$704.00 0 I $0.00 88 -$704.00 88.00 -$704.00 100.00%
TOTAL SCHEDULE 3 $6,584.501 $6,979.64 $12,860.14 I $54.00 $13,823.00 $12,860.14 100.00%
* (See notes at the bottom of sheet 2)
TOTAL PROJECT $1,685,929.00 $254,827.74 $1,940,052.74 $35,328.80 $1,906,444.80 $1,940,052.74 100.00%
Description TOTAL TO DATE
TOTAL $1,940,052.74
LESS 5%RETAINAGE $0.00
SUBTOTAL $1,940,052.74
LESS PREVIOUS PAYMENTS $1,813,196.80
TOTAL AMOUNT DUE CONTRACTOR $126,855.94
CERTIFICATION OF CONTRACTOR-I HEREBY CERTIFY that the work performed and the materials supplied to date,as shown on this periodic cost estimate, represent the actual value of accomplishment under the terms of this contract in conformity with approved plans and specifications;that quantities shown were properly determined and are correct;and that there has been full compliance
with all labor provisions included in the contract identified above,and in all subcontracts made under this contract, including payment of subcontractor work completed and included to date.
10/25/2021
BY: BY: 0—LS—�
Kimley-Horn and Associates, Inc. Date American Road Maintenance Date
* Notes:
1. P-101-5.2-CORR (CORRECTION) -->This line item was added to balance out an over-payment on Payment Application#1 of$704.00.The wrong unit price was applied to this line item (26$ instead of 18$).
2. Correction line item added to P-101-5.2 and P-403-5.1 balance prices from CCO2. Unit prices updated per CCO2.
Kimley-Horn
APPLICATION AND CERTIFICATE FOR PAYMENT
ASPEN/PITKIN COUNTY AIRPORT
ASPEN, COLORADO
RUNWAY AND TAXIWAY PAVEMENT MAINTENANCE
CDOT GRANT NO: 20-ASE-01
RUNWAY AND TAXIWAY
PROJECT TITLE PAVEMENT MAINTENANCE PROJECT NO. AIP NO. 3-08-0003-056
CONSULTANT: KIMLEY-HORN AND ASSOCIATES
CONTRACTOR: AMERICAN ROAD MAINTENANCE
Application No. 3 Period From: 10/1/2021 To: 10/31/2021
Application is made for payment, as shown below, and on the attached Construction Progress Estimate
Form, in accordance with the Contract Documents:
Original Contract Price: $ 1,685,929.00
Approved Change Orders and Dates:
CO1: MAY 3, 2021 $52,362.00
CO2: MAY 19, 2021 $188,397.00
CO3: OCT 8, 2021 $13,364.74
Adjusted Contract Price $1,940,052.74
Total Amount Due to Date
(from attached Construction Progress Estimate) $ 126,855.94
Retainage: 0° $ 0.00
Total Earned Less Retainage $
Less Previous Certificates for Payment $126,855.94
Currently Payment Due $ 126,855.94
MOBILZATION: 5/10/2021
Notice to Proceed CONSTRUCTION: 5/17/2021
Date of Completion ANTICIPATED: 10/31/2021
Time Used
complete 100.00 %
ASPEN/PITKIN COUNTY AIRPORT C-15 CONTRACT FORMS
RUNWAY AND TAXIWAY PAVEMENT MAINTENANCE ISSUED FOR CONSTRUCTION
Kimley-Horn
Contractors Certification Engineers Certification
The undersigned Contractor certifies that the The Engineer has reviewed this application,
work covered by this Application for Payment accompanying data and schedules and having
has been completed in accordance with the made on-site observation of the work consistent
Contract Documents that all amounts have been with his assigned responsibilities certifies that to
paid by him for work for which previous his best knowledge and belief, the quality of the
Certificates for Payment were issued and work performed is in accordance with the
payments received from the Owner, that the Contract Documents, that the work has
current payment shown is that due. The progressed as indicated herein, and that the
contractor also certifies that the attached DBE Contractor is entitled payment to the amount
Participation Progress Report is true and above shown.
accurate.
CONTRACTOR
- CONSULTANT
By ‘t;,X_
By
Date 10/8/21 10/25/2012
Date
ASPEN/PITKIN COUNTY AIRPORT C-16 CONTRACT FORMS
RUNWAY AND TAXIWAY PAVEMENT MAINTENANCE ISSUED FOR CONSTRUCTION
DocuSign
Certificate Of Completion
Envelope Id:045F6C12213D4B2EA937E1447C8CD3AF Status:Completed
Subject:ARM I Pitkin County Change Order 111.20 C for Review and Signature
Source Envelope:
Document Pages:7 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:65.38.144.66
Record Tracking
Status:Original Holder:Pitkin County Procurement Location: DocuSign
11/3/2021 2:10:43 PM Procurement@PitkinCounty.com
Signer Events Signature Timestamp
Dan Bartholomew Sent: 11/3/2021 2:22:59 PM
dan.bartholomew@aspenairport.com ° °` '°°" "' Viewed: 11/3/2021 5:35:38 PM
Airport Director Signed: 11/4/2021 11:33:59 AM
Aspen/Pitkin County Airport
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
Rich Englehart '. '� Sent: 11/4/2021 12:07:36 PM
rich.englehart@pitkincounty.com flA4P- ,4 Viewed: 11/4/2021 12:09:43 PM
Deputy County Manager Signed: 11/4/2021 12:09:55 PM
Pitkin County
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Using IP Address:65.38.144.66
(None)
Electronic Record and Signature Disclosure:
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Marc Miller ._ Sent: 11/4/2021 12:09:57 PM
n, �
marc.c.miller@faa.gov U''L L.t r Resent: 11/16/2021 7:42:19 AM
Security Level: Email,Account Authentication Viewed: 11/16/2021 8:13:10 AM
(None) Signed: 11/23/2021 8:51:25 AM
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Using IP Address: 162.58.82.135
Electronic Record and Signature Disclosure:
Accepted: 11/16/2021 8:13:10 AM
ID:7624c1 a8-409a-4bbb-a4a5-09566157352d
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
Certified Delivery Events Status Timestamp
Rich Englehart VIEWED Sent: 11/4/2021 11:34:01 AM
Rich.Englehart@PitkinCounty.com Viewed: 11/4/2021 12:07:35 PM
Deputy County Manager
Pitkin County Using IP Address:65.38.144.66
Security Level: Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Carbon Copy Events Status Timestamp
Pitkin County Procurement COPIED Sent: 11/23/2021 8:51:27 AM
procurement@pitkincounty.com Resent: 11/23/2021 8:51:36 AM
Procurement Viewed: 11/23/2021 9:15:25 AM
Pitkin County
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(None)
Electronic Record and Signature Disclosure:
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Accounts Payable COPIED Sent: 11/23/2021 8:51:28 AM
AP@pitkincounty.com
Accounts Payable
Pitkin County
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(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Evelyn Cruz COPIED Sent: 11/23/2021 8:51:29 AM
evelyn.cruz@aspenairport.com
Aspen/Pitkin County Airport
Security Level: Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted:4/12/2021 2:10:41 PM
ID:c1bc55da-6ec1-49bb-8432-a0d7de7ce362
Company Name:Pitkin County,Colorado
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 11/3/2021 2:22:59 PM
Certified Delivered Security Checked 11/16/2021 8:13:10 AM
Signing Complete Security Checked 11/23/2021 8:51:25 AM
Completed Security Checked 11/23/2021 8:51:29 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:Marc Miller, Evelyn Cruz
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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 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.