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Home My WebLink Aboutbocc.con.amended.136.16 E 8/30/2021 CDC) pfKIN Pitkin County Procurement Cover Sheet COUNT — @RCN 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 136.16 E Project Name Adult and Family Services Protection/On-Call Supervisory Support Contractor Tracey Branch Budget Line Item 11234342.531000.10035 $ 3,000.00 $Additional Budget Line $ Item(s) $ _ (Please fully allocate New Contract Total) $ 3,000.00 Procurement Method: None Type: Services/Maintenance Contract Start Date 12/15/2016 Contract End Date 12/31/2022 Contract Type Contract Extension Retainage No If this is a new contractor, please enter the New Vendor information into Munis for workflow approval. Contact Information: Department Adult&Family Svcs County Representative Matt McGaugh County Representative (970) 429-2042 Phone Provide a brief description of the Contract or Change Order: Extension of Contract for 2022 term. Contract Value Summary: Original Contract Amount $ 2,250.00 Previous Change Order/Amendment Amount $ 10,500.00 This Change order/Amendment amount $ 3,000.00 Contract Total $ 15,750.00 Contract#: 136.16 Rev. 2018.06.13 btf Budget Line Item#: 11234342.531000.10035 41)iTKIN COUNT - @Z)CN - CHANGE ORDER/ CONTRACT AMENDMENT Change Order Number: 136.16 E OWNER: CONTRACTOR: Pitkin County, Colorado Tracey Branch 530 E. Main St., Suite#302 PO Box 5791 Aspen, CO 81611 Eagle, CO 81631 The Provision of Adult and Family Services Protection/On Call Supervisory Support (the "Contract") dated December 15, 2016 between the Board of County Commissioners of Pitkin County, Colorado (the "County") and Tracey Branch(the "Contractor"), is hereby amended as follows: Description of Change: Extension of Contract term for one (1)year. Contract end date is now December 31, 2022. Reason for Change: Extension of Contract. Original Contract Amount $ 2,250.00 Previous Change Order/Amendment Amount $ 10,500.00_1 This Change Order/Amendment Amount $ 3,000.00 New Contract Total $ 15,750.00 *Increases over$25,000 and/or 10%(single increase or accumulative)of original contract must have County Manager signature. 1 Contract#: 136.16 Rev. 2018.06.13 btf Budget Line Item#: 11234342.531000.10035 In all other respects, the Contract is in full force and effect and remains unchanged by this Amendment. TRACEY BRANCH trawl brata Mar-21-2022 Tracey Branch Date Contracted On Call Supervisor PITKIN COUNTY, COLORADO I1Jt4J Ault4 Mar-21-2022 Matt Mcgaugh Date Adult & Family Services Manager *Increases over$25,000 and/or 10%(single increase or accumulative)of original contract must have County Manager signature. 2 DocuSign Certificate Of Completion Envelope Id:0FD591451 B8F4A609F8409C4EA9CE3DB Status:Completed Subject:Tracey Branch I Pitkin County Contract Amendment 136.16 E for Review and Signature Source Envelope: Document Pages:3 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:216.237.91.144 Record Tracking Status:Original Holder:Pitkin County Procurement Location: DocuSign 3/21/2022 12:33:35 PM Procurement@PitkinCounty.com Signer Events Signature Timestamp Matt Mcgaugh A', ',,I Sent:3/21/2022 12:35:13 PM matt.mcgaugh@pitkincounty.com '�""'�^ Viewed:3/21/2022 12:36:33 PM Adult&Family Services Manager Signed:3/21/2022 12:36:54 PM Pitkin County Security Level: Email,Account Authentication Signature Adoption: Pre selected Style (None) Using IP Address:208.72.66.92 Electronic Record and Signature Disclosure: Not Offered via DocuSign Tracey Branch t Sent:3/21/2022 12:36:55 PM tracey.branch@eaglecounty.us I�' '' Viewed:3/21/2022 2:06:55 PM Contracted On Call Supervisor Signed:3/21/2022 2:07:45 PM Security Level: Email,Account Authentication (None) Signature Adoption: Pre-selected Style Using IP Address:71.211.41.234 Electronic Record and Signature Disclosure: Accepted:2/24/2021 10:07:02 AM ID:7a6b601d-274d-4e9a-8a94-f5e480237a44 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:3/21/2022 2:07:46 PM procurement@pitkincounty.com Resent:3/21/2022 2:07:49 PM Procurement Viewed:3/21/2022 2:42:21 PM 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:3/21/2022 2:07:47 PM AP@pitkincounty.com Accounts Payable 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 3/21/2022 12:35:13 PM Certified Delivered Security Checked 3/21/2022 2:06:55 PM Signing Complete Security Checked 3/21/2022 2:07:45 PM Completed Security Checked 3/21/2022 2:07:47 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:Tracey Branch 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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