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HomeMy WebLinkAboutbocc.con.amended.002.20 C-2-B8/30/2021 CDD Contract Information Contract Number Project Name Contractor Budget Line Item 11836361.531000.10086 Procurement Method: Type: Contract Start Date Contract End Date Contract Type Retainage If this is a new contractor, please enter the New Vendor information into Munis for workflow approval. Contact Information: Department County Representative Jessie Young County Representative Phone (970) 429-6169 Provide a brief description of the Contract or Change Order: Contract Value Summary: $ 17,500.00 $ - $ 93,162.00 $ 110,662.00 002.20 C-2-B 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 No Aspen Village Pedestrian Bridge Alternatives SGM, Inc. $ 93,162.00 Additional Budget Line Item(s) (Please fully allocate New Contract Total) $ - $ - $ - $ 93,162.00 Formal Services/Maintenance 3/16/2020 12/31/2022 Change Order/Contract Amendment Open Space & Trails Change Order to: (1) extend the Task Order End Date to 12/31/2022; (3) allocate additional funding in the amount of $93,162.00; and (2) expand the Task Order Scope of Work to include Contractor engineering, consulting, and project management services through the design and construction phase of the Aspen Village Pedestrian Bridge project. Original Contract Amount Previous Change Order/Amendment Amount This Change order/Amendment amount Contract Total Contract #: 002.20 Rev. 2018.06.13 btf Budget Line Item #: 11836361.531000.10086 *Increases over $25,000 and/or 10% (single increase or accumulative) of original contract must have County Manager signature. 1 CHANGE ORDER / CONTRACT AMENDMENT Change Order Number: 002.20 C-2 B OWNER: Pitkin County, Colorado 530 E. Main St., Suite #302 Aspen, CO 81611 CONTRACTOR: SGM, Inc. 118 W 6th St., Sutie 200 Glenwood Springs, CO 81601 The Provision of Aspen Village Pedestrian Bridge Alternatives agreed to in the March 16, 2020 Task Order # 002.20 C-2, as amended (the "Task Order"), made pursuant to the On-Call Engineering Services Master Service Agreement (the “Contract”) dated January 1, 2020 between the Board of County Commissioners of Pitkin County, Colorado (the “County”) and SGM, Inc. (the “Contractor”), is hereby further amended as follows: Description of Change: 1. The Task Order End Date is extended from 12/31/2021 to 12/31/2022; 2. Additional funding is allocated in the amount of Ninety-Three Thousand One Hundred Sixty- Two dollars and No cents ($93,162.00) to compensate Contractor for the additional services listed below; and 3. The Contractor’s Obligations under the Task Order are expanded to incorporate the additional scope of work and services described in the attached Contractor Proposal (“Attachment A”) and summarized below: Phase 1 – Project Management, Agency Coordination, and Meetings This phase includes time for general project management, establishing and managing the design schedule, team coordination and scheduling, invoicing, and communication with the County. The following key tasks are included: · Project Schedule-Establish and maintain the design schedule. Keep OST aware of project progress and keep design team on task to meet milestones. · Monthly Invoicing-Review monthly invoices and provide memo cover sheet summarizing project status updates, review of project budget, and review of project schedule. · Internal Coordination and Communication-Facilitate coordination and information sharing between the County Project Manager and the design team. Contract #: 002.20 Rev. 2018.06.13 btf Budget Line Item #: 11836361.531000.10086 *Increases over $25,000 and/or 10% (single increase or accumulative) of original contract must have County Manager signature. 2 · CDOT Coordination-SGM will lead the coordination with CDOT. SGM anticipates that a Special Use Permit will be required from CDOT. SGM will develop the deliverables necessary for this permit, attend the necessary meetings, and ensure the proper process is followed to get these permits. · Other Agency Coordination-Contractor anticipates significant coordination with RFTA, Bureau of Land Management, and the Eli Cerise Ditch Company. Contractor is assuming the OST will take the lead on this coordination and SGM will provide support and documentation as needed. Additionally, the following meetings are anticipated: · Project Kickoff Meeting-The SGM project manager and discipline leads will meet with OST at the beginning of the work. The purpose of this meeting is to establish goals, methodologies, and schedule for the project. This meeting will provide initial direction to the design team and strategies to avoid potential pitfalls. Minutes of this meeting will be provided to OST. · 60% Design Review Meeting-The 60% design plans will be submitted two weeks before this meeting. This meeting will give OST the opportunity to address any questions, coordination items, plan set corrections, etc. Comments from this meeting will be addressed and incorporated in the final design set. · Final Design Meeting-The final design plans will be submitted two weeks before this meeting. This meeting will give OST the opportunity to address any questions, coordination items, plan set corrections, etc. Comments from this meeting will be addressed and incorporated in the bid documents. Phase 2 -- Survey This task will include providing a boundary survey of the relevant parcels adjacent to the project and staking property corners. A topographic survey in the vicinity of the proposed bridge crossing will be provided down to rivers edge. This survey will be blended with available lidar data where possible to reduce field time. No cross sections will be provided as it is assumed that hydraulics will not be required. The wetland boundary will be delineated by Contractor’s environmental team and will be surveyed in. Visible utilities and locates provided by utility owners will be surveyed. Contractor anticipates that the boundary work will happen first along with the topographic survey at the top of the banks. The limits of the survey will cover the area required for proposed Alternative 2 as well as an alignment that passes just outside of the BLM parcel in case the Contractor and OST can’t receive the necessary approvals. Phase 3 – 60% Design This task includes all work to submit the 60% or intermediate design plans, specifications, and estimate. An intermediate design is considered to have all project geometry set and all key civil and structural elements sized. On the structural side, items such as reinforcement, connection details, railing types, etc. may not be fully defined in this phase. The structure is assumed to be a simple span prefabricated truss bridge. The following tasks are anticipated: · Complete the intermediate design of the trail that will tie into the bridge from the SH82 Underpass side to the bridge and from the Rio Grande Trail to the bridge. · Complete the intermediate design of the bridge foundation, substructure, and connections to the prefabricated superstructure. Contract #: 002.20 Rev. 2018.06.13 btf Budget Line Item #: 11836361.531000.10086 *Increases over $25,000 and/or 10% (single increase or accumulative) of original contract must have County Manager signature. 3 · Complete the intermediate specification package. · Complete the preliminary geotechnical report. · Complete the intermediate quantities and engineer’s opinion of probable cost. Phase 4 – 100% Design This task includes all work to submit the final design plans, specifications, and estimate. The intent of this submittal is that all project elements are fully designed and detailed. With this submittal, once final review comments are incorporated, this should be ready to be advertised. · Complete the final design of the trail that will tie into the bridge from the SH82 Underpass side to the bridge and from the Rio Grande Trail to the bridge. · Complete the final design of the bridge foundation, substructure, and connections to the prefabricated superstructure. · Complete the final geotechnical report. · Complete final bid tabulation. · Complete 60% comment responses. · Prepare bid-ready plans and specifications for the complete project (bridge and trail). · Prepare a final engineer’s opinion of probable cost. Phase 5 – Bid Support This task includes design support through bid phase. This includes general coordination with OST, attending the pre-bid meeting, responding to contractor questions, submitting addenda as needed, and evaluating bids and making recommendations. Phase 6 – CDOT Environmental Clearance This phase includes all CDOT environmental assessment and compliance documentation for the proposed bridge. Contractor’s role will be to complete the CDOT ECIS checklist, providing narrative responses and supporting material where necessary to address CDOT’s list of environmental resource concerns. Contractor will also support CDOT staff as necessary in their review to ensure the timely completion of the Form 128, which is CDOT’s documentation of compliance and is required to allow the approval of third-party projects for construction. Services will include the following: · Biological surveys and reporting for federal and state-listed rare plants and animals, invasive and noxious weeds, and raptors. · Wetland delineation if necessary, or documentation of no impact if no jurisdictional resources are present. Permitting of impacts is not included at this time and would be addressed at a later stage of the project if impacts cannot be avoided. · Hazardous Materials · History Colorado cultural resource File Search, and a subsequent pedestrian survey if necessary · Stormwater Construction Permit application · Coordination with your staff to address CDOT concerns and ensure the incorporation of necessary plan details and specifications. · Coordination with Colorado Parks and Wildlife in accordance with Senate Bill 40 (SB40) Wildlife Certification. Contract #: 002.20 Rev. 2018.06.13 btf Budget Line Item #: 11836361.531000.10086 *Increases over $25,000 and/or 10% (single increase or accumulative) of original contract must have County Manager signature. 4 Proposed Schedule The following schedule is proposed for this work: · Field Survey (April-May 2022) · Geotechnical Investigation and Recommendations (April-May 2022) · 60% Design (June-October 2022) · 100% Design Submittal (October 2022-February 2023) · Project Advertisement (March 2023) Reason for Change: County desires to continue and expand Contractor services for the next phase of the Aspen Village Pedestrian Bridge project. Original Contract Amount $ 17,500.00 Previous Change Order/Amendment Amount $ - This Change Order/Amendment Amount $ 93,162.00 New Contract Total $ 110,662.00 Contract #: 002.20 Rev. 2018.06.13 btf Budget Line Item #: 11836361.531000.10086 *Increases over $25,000 and/or 10% (single increase or accumulative) of original contract must have County Manager signature. 5 In all other respects, the Contract is in full force and effect and remains unchanged by this Amendment. SGM, INC. ________________________________________________ !#VENDOR SIGNATURE#! Date PITKIN COUNTY, COLORADO RECOMMENDED FOR APPROVAL: _________________________________________________ !#DEPARTMENT REPRESENTATIVE#! Date MANAGER APPROVAL: ________________________________________________ !#COUNTY MANAGER#! Date Planning/Outreach Manager - Open Space and Trails Jessie Young Apr-06-2022 Mike Fowler Project Manager Apr-11-2022 Rich Englehart Apr-11-2022 Deputy County Manager Pitkin County Open Space Aspen Village Pedestrian Bridge Final Design Letter Scope OVERVIEW The Aspen Village Pedestrian Bridge design development was initiated in 2020. The first task that SGM completed was an alternatives analysis of different bridge types at a conceptual design level. The result of this analysis was the selection of a preferred alignment and bridge type. The alignment selected was Alignment 2 and the bridge type was a prefabricated steel truss bridge. See “Pitkin County Open Space & Trails Aspen Village Pedestrian Bridge Alternatives Report” for further detail. All work in this initial phase was based on aerial imagery. No on-the-ground survey was completed during this phase. PROPOSED SCOPE OF WORK SGM proposes to execute the overall project through the following tasks: Phase 1 – Project Management, Agency Coordination, and Meetings This phase includes time for general project management, establishing and managing the design schedule, team coordination and scheduling, invoicing, and communication with the County. The following key tasks are included: · Project Schedule-Establish and maintain the design schedule. Keep OST aware of project progress and keep design team on task to meet milestones. · Monthly Invoicing-Review monthly invoices and provide memo cover sheet summarizing project status updates, review of project budget, and review of project schedule. · Internal Coordination and Communication-Facilitate coordination and information sharing between the County Project Manager and the design team. · CDOT Coordination-SGM will lead the coordination with CDOT. We anticipate that a Special Use Permit will be required from CDOT. SGM will develop the deliverables necessary for this permit, attend the necessary meetings, and ensure the proper process is followed to get these permits. · Other Agency Coordination-We anticipate significant coordination with RFTA, Bureau of Land Management, and the Eli Cerise Ditch Company. We are assuming the OST will take the lead on this coordination and SGM will provide support and documentation as needed. Additionally, the following meetings are anticipated: · Project Kickoff Meeting-The SGM project manager and discipline leads will meet with OST at the beginning of the work. The purpose of this meeting is to establish goals, methodologies, and schedule for the project. This meeting will provide initial direction to the design team and strategies to avoid potential pitfalls. Minutes of this meeting will be provided to OST. · 60% Design Review Meeting-The 60% design plans will be submitted two weeks before this meeting. This meeting will give OST the opportunity to address any questions, coordination items, plan set corrections, etc. Comments from this meeting will be addressed and incorporated in the final design set. · Final Design Meeting-The final design plans will be submitted two weeks before this meeting. This meeting will give OST the opportunity to address any questions, coordination items, plan set corrections, etc. Comments from this meeting will be addressed and incorporated in the bid documents. Pitkin County Open Space Aspen Village Pedestrian Bridge Final Design Letter Scope Phase 2 -- Survey This task will include providing a boundary survey of the relevant parcels adjacent to the project and staking property corners. A topographic survey in the vicinity of the proposed bridge crossing will be provided down to rivers edge. This survey will be blended with available lidar data where possible to reduce field time. No cross sections will be provided as it is assumed that hydraulics will not be required. The wetland boundary will be delineated by our environmental team and will be surveyed in. Visible utilities and locates provided by utility owners will be surveyed. We anticipate that the boundary work will happen first along with the topographic survey at the top of the banks. The limits of the survey will cover the area required for proposed Alternative 2 as well as an alignment that passes just outside of the BLM parcel in case we can’t receive the necessary approvals. Phase 3 – 60% Design This task includes all work to submit the 60% or intermediate design plans, specifications, and estimate. An intermediate design is considered to have all project geometry set and all key civil and structural elements sized. On the structural side, items such as reinforcement, connection details, railing types, etc. may not be fully defined in this phase. The structure is assumed to be a simple span prefabricated truss bridge. The following tasks are anticipated: · Complete the intermediate design of the trail that will tie into the bridge from the SH82 Underpass side to the bridge and from the Rio Grande Trail to the bridge. · Complete the intermediate design of the bridge foundation, substructure, and connections to the prefabricated superstructure. · Complete the intermediate specification package. · Complete the preliminary geotechnical report. · Complete the intermediate quantities and engineer’s opinion of probable cost. Phase 4 – 100% Design This task includes all work to submit the final design plans, specifications, and estimate. The intent of this submittal is that all project elements are fully designed and detailed. With this submittal, once final review comments are incorporated, this should be ready to be advertised. · Complete the final design of the trail that will tie into the bridge from the SH82 Underpass side to the bridge and from the Rio Grande Trail to the bridge. · Complete the final design of the bridge foundation, substructure, and connections to the prefabricated superstructure. · Complete the final geotechnical report. · Complete final bid tabulation. · Complete 60% comment responses. · Prepare bid-ready plans and specifications for the complete project (bridge and trail). · Prepare a final engineer’s opinion of probable cost. Pitkin County Open Space Aspen Village Pedestrian Bridge Final Design Letter Scope Phase 5 – Bid Support This task includes design support through bid phase. This includes general coordination with OST, attending the pre-bid meeting, responding to Contractor questions, submitting addenda as needed, and evaluating bids and making recommendations. Phase 6 – CDOT Environmental Clearance (Optional) This optional phase includes all CDOT environmental assessment and compliance documentation for the proposed bridge. Our role would be to complete the CDOT ECIS checklist, providing narrative responses and supporting material where necessary to address CDOT’s list of environmental resource concerns. We would also support CDOT staff as necessary in their review to ensure the timely completion of the Form 128, which is CDOT’s documentation of compliance and is required to allow the approval of third-party projects for construction. While the proposed alignment may fly over lands under federal management (BLM, FHWA), our understanding is that this scope of work does not include an environmental assessment under NEPA. Therefore, we assume that this is a non-federal action, and that CDOT will be the lead agency for permit review and compliance. Services will include the following: · Biological surveys and reporting for federal and state-listed rare plants and animals, invasive and noxious weeds, and raptors. · Wetland delineation if necessary, or documentation of no impact if no jurisdictional resources are present. Permitting of impacts is not included at this time and would be addressed at a later stage of the project if impacts cannot be avoided. · Hazardous Materials · History Colorado cultural resource File Search, and a subsequent pedestrian survey if necessary · Stormwater Construction Permit application · Coordination with your staff to address CDOT concerns and ensure the incorporation of necessary plan details and specifications. · Coordination with Colorado Parks and Wildlife in accordance with Senate Bill 40 (SB40) Wildlife Certification Items Excluded From this Scope of Work The following items are not included in this Scope of Work: · Hydraulics, River Cross Sections, and Floodplain Development Permit Support-Based on our review of the available topographic data (not obtained from field survey), the low chord of this bridge will be substantially above the Base Flood Elevation and the abutments will be well outside of the 30’ setback from ordinary highwater. Therefore, no hydraulic analysis, permitting, river surveying, FEMA LOMR or CLOMR, or no rise certification is anticipated. · Compliance with Subsurface Utility Engineering Law-Based on our review of the project, contiguous areas of excavation will not be large enough to trigger the requirements of the SUE law. Utility engineering will therefore be limited to making an 811 call, surveying in surface utilities, and located underground utilities, and accommodating those utilities in the project. Pitkin County Open Space Aspen Village Pedestrian Bridge Final Design Letter Scope · Front End Specification Documents-We will provide all technical Specifications for the constructed elements, but front-end Specification documents will be provided by the County. · Construction Support-This scope of work does not include construction engineering, observation, or support. · Permitting for Specific Agencies-This scope does not include permitting for any agencies other than CDOT. · Plat Revisions, Appraisals, Easement Agreement and Exhibits Proposed Schedule The following schedule is proposed for this work: · Field Survey (April-May 2022) · Geotechnical Investigation and Recommendations (April-May 2022) · 60% Design (June-October 2022) · 100% Design Submittal (October 2022-February 2023) · Project Advertisement (March 2023) Fee Schedule Time and compensation by Client to SGM will be on the bases of time and materials not to exceed. Our fee schedule is provided below. The not to exceed amounts for each phase are: · Phase 1: Project Management, Agency Coordination & Meetings $11,177 · Phase 2: Survey $12,588 · Phase 3: 60% Design $36,902 · Phase 4: 100% Design $20,658 · Phase 5: Bid Phase Coordination with County $ 1,837 · Phase 6: CDOT Environment Clearance (Optional) $10,000 PREPARED BY: MC Frymoyer PROJECT: ASPEN VILLAGE PED BRIDGE DATE: 3/31/2022 CLIENT: PITKIN COUNTY OPEN SPACE & TRAILS REVISION: 2.0 No. Code Personnel Description Name Rate Hours Salary Labor 1 PM Project Manager Mark Frymoyer $167 49 8,183$ 2 SE Structural Engineer Marijean Frymoyer $167 188 31,396$ 3 CE Civil Engineer Ashley Cline $153 49 7,497$ 4 CD Civil Designer Michael Morrison $102 69 7,038$ 5 PLS Land Surveyor Shawn Binion $140 25 3,500$ 6 SPM Survey Project Manager Josh Wilson $120 32 3,840$ 7 FS Field Survey Crew 2-Person Crew $212 34 7,208$ Subtotal 446 68,662$ No. Code Description Total Cost 1 RJE Geotechnical RJ Engineering 14,500$ Subtotal 14,500$ Total Cost 1.0 Project Management, Agency Coordination & Meetings 11,177$ 2.0 Survey 12,588$ 3.0 60% Design 36,902$ 4.0 100% Design 20,658$ 5.0 Bid Phase Coordination w/County 1,837$ Total 83,162$ Total Cost 6.0 CDOT Environmental Clearance (Optional)10,000$ Phase SGM Hours and Labor Charges Subconsultants Cost Breakdown by Phase Phase Name Optional Scope Items Print Date: 3/31/2022 Page 1 of 1 SGM Confidential ASPEN VILLAGE PED BRIDGE Subtotal Design of Hours Cost 1.0 Project Management, Agency Coordination & Meetings 1.1 Project Management (3 Hrs/Month x 6 Months)18 18 $3,006 1.2 Meetings 0 $0 Project Kickoff Meeting 1 1 1 3 $487 60% Design Review Meeting 1 1 1 3 $487 Final Design Meeting 1 1 1 3 $487 1.3 CDOT Coordination 4 14 2 7 27 $4,190 1.4 Other Agency Coordination 4 4 2 7 17 $2,520 Subtotal: Phase 1.0 29 21 3 4 14 0 0 71 $11,177 $0 2.0 Survey 2.1 Field Work 4 4 $480 Boundary Survey 14 14 $2,968 Topo 14 14 $2,968 Locate Surface Utilities 6 6 $1,272 2.2 Office 7 4 11 $1,460 Prep for Stakeout Coordinates 4 4 $480 Plat Drafting Base Map 4 4 $480 Utility Locate Requests 4 4 $480 Basemap Updates as Needed 4 4 $480 2.3 Deliverables 0 $0 Base Map (Electronic File)4 8 12 $1,520 Subtotal: Phase 2.0 0 0 0 0 11 32 34 77 $12,588 $0 3.0 60% Design 3.1 Trail Design and Development 1 2 8 11 $1,289 3.2 Bridge Design 16 16 $2,672 3.3 Utility Coordination 1 8 5 14 $2,268 3.4 QA/QC 21 8 29 $4,731 3.5 Geotechnical Investigation 0 $0 $14,500 3.5 Deliverables 0 $0 60% Plans 20 5 8 33 $4,921 60% Project Special Provisions 1 8 9 $1,503 60% Quantities 8 1 10 19 $2,509 60% Engineer's Opinion of Probable Cost 8 1 10 19 $2,509 Draft Geotechnical Report 0 $0 Subtotal: Phase 3.0 3 89 22 36 0 0 0 150 $22,402 $14,500FSRJEPHASES AND TASKS SECECDPLSSPMSUBS SCHEDULE OF FEES PMSGM PERSONNEL HOURS SGM Print Date: 3/31/2022 Page 1 of 1 SGM Confidential Certificate Of Completion Envelope Id: C0F82A37E1CC4496B266B7737DBA8283 Status: Completed Subject: SGM, Inc. | Pitkin County Task Order Amendment 002.20 C-2-B 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: 75.110.134.54 Record Tracking Status: Original 4/6/2022 6:59:29 AM Holder: Pitkin County Procurement Procurement@PitkinCounty.com Location: DocuSign Signer Events Signature Timestamp Jessie Young jessie.young@pitkincounty.com Planning/Outreach Manager - Open Space and Trails Security Level: Email, Account Authentication (None) Signature Adoption: Drawn on Device Signed by link sent to jessie.young@pitkincounty.com Using IP Address: 65.38.144.66 Sent: 4/6/2022 7:04:05 AM Viewed: 4/6/2022 12:22:25 PM Signed: 4/6/2022 12:32:59 PM Electronic Record and Signature Disclosure: Accepted: 4/6/2022 12:22:25 PM ID: 2e6f82df-2260-45d3-aaa8-a76697f776ee Company Name: Pitkin County, Colorado Mike Fowler mikef@sgm-inc.com Project Manager Security Level: Email, Account Authentication (None)Signature Adoption: Pre-selected Style Signed by link sent to mikef@sgm-inc.com Using IP Address: 208.72.68.35 Sent: 4/6/2022 12:33:00 PM Viewed: 4/11/2022 12:37:02 PM Signed: 4/11/2022 12:37:30 PM Electronic Record and Signature Disclosure: Accepted: 4/11/2022 12:37:02 PM ID: 48454a7e-dbe8-4adf-a874-9d6a31fda839 Company Name: Pitkin County, Colorado Rich Englehart rich.englehart@pitkincounty.com Deputy County Manager Pitkin County Signing Group: County Manager Group Security Level: Email, Account Authentication (None) Signature Adoption: Pre-selected Style Signed by link sent to rich.englehart@pitkincounty.com Using IP Address: 65.38.144.66 Sent: 4/11/2022 12:37:32 PM Viewed: 4/11/2022 2:05:19 PM Signed: 4/11/2022 2:05:40 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 Pitkin County Procurement procurement@pitkincounty.com Procurement Specialist Pitkin County Security Level: Email, Account Authentication (None) Sent: 4/11/2022 2:05:41 PM Resent: 4/11/2022 2:05:45 PM Viewed: 4/11/2022 2:38:08 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: 4/11/2022 2:05:42 PM Electronic Record and Signature Disclosure: Not Offered via DocuSign Kim Arensdorf kim.arensdorf@pitkincounty.com Administrative Specialist Security Level: Email, Account Authentication (None) Sent: 4/11/2022 2:05:43 PM Electronic Record and Signature Disclosure: Accepted: 12/15/2021 11:10:46 AM ID: 9ae44e6d-4db3-4e13-ad61-3cd162cdf888 Company Name: Pitkin County, Colorado Witness Events Signature Timestamp Notary Events Signature Timestamp Envelope Summary Events Status Timestamps Envelope Sent Hashed/Encrypted 4/6/2022 7:04:05 AM Certified Delivered Security Checked 4/11/2022 2:05:19 PM Signing Complete Security Checked 4/11/2022 2:05:40 PM Completed Security Checked 4/11/2022 2:05:43 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. 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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.