HomeMy WebLinkAboutbocc.con.101.26THIS UTILITY RELOCATION AND REIMBURSEMENT AGREEMENT (“Agreement’), made this
1st day of July 2026, is by and between Pitkin County, Colorado, hereinafter referred to as the
“County”, and Lumen Technology, Inc, hereinafter referred to as the “Owner”.
WHEREAS:
1. The County is the owner and sponsor of the Aspen/Pitkin County Airport (the “Airport”). The
County is undertaking a major redevelopment of the Airport, including but not limited to
relocation of the runway and construction of a new terminal building (the “Project”); and
2. The Project authorized by the County and the Federal Aviation Administration that necessitates
this Agreement is being administered by the County; and
3. The County has deemed it necessary to make certain airport and roadway improvements on
the Airport property and the Owl Creek Road system, generally located approximately 0.33
miles from Colorado State Highway 82 on Owl Creek Road and various locations across the
south portion of the Airport, as shown in the “Exhibit A” attached and incorporated herein; and
4. The proposed airport and runway improvements will necessitate the relocation, adjustment or
installation of certain facilities of the Owner, as follows: Relocation of fiber and phone lines,
plans for which are shown in the attached “Exhibit B” and which were prepared in the form and
manner required by the applicable local, state, and federal standards; and
5. The County’s general contractor, Kiewit Corporation (the “Contractor”), shall install the conduit
vaults, and other appurtenances for the Owner’s fiber and phone lines, as shown in Exhibit B;
and
6. The Owner shall supply the vault, handholes, pedestal to the County’s Contractor, Kiewit, in
time for installation in August of 2026.
7. The Owner shall pull fiber and splice at their expense within timelines established in
coordination meetings, but no later than 9/18/2026.
8. The Owner will be issued a Revocable Right-of-Way Permit from Pitkin County Public Works in
the form of Exhibit C, attached and incorporated herein, and will be held to the conditions of
that permit for areas within Pitkin County Right-of-Way; and
9. The County desires to implement the relocation, adjustment or installation of Owner's facilities
as soon as possible by entering into this Agreement with said Owner.
NOW, THEREFORE, it is hereby agreed that:
PITKIN COUNTY, COLORADO
UTILITY RELOCATION AND REIMBURSEMENT AGREEMENT
Project Name:
ASE Airport Modernization –
Lumen Relocate
Location
Aspen Airport and Owl Creek
Road
bocc.con.101.26
1. The Owner and County shall split as highlighted below the costs of relocating, adjusting or
installing Owner's facilities. The lines appear in properties that are partially in easements and
partially in non-easement areas.
a. The Owner shall be responsible for placing fiber, splicing, materials and other
duties as organized by Kiewit and the County.
b. The County, via Kiewit shall install all vaults, conduit and other items as
coordinated with the County
2. All claims for right-of-way or easement cost reimbursement shall be invoiced separately from
other cost items.
3. Upon execution of this Agreement by both Parties hereto, the County will, by its Contractor,
relocate and place items as described in Exhibit B. Once this work is completed, the County
will authorize the Owner to proceed with any additional work, connections, and completion
work, to the facilities. The Owner and County agree to prosecute such Work diligently to
completion in such manner as to not result in avoidable interference or delay to the County’s
construction of Owl Creek Road or the other Airport modernization work. Owner agrees to
complete its relocation work promptly after installation of the conduit and other appurtenances
is completed but in no event later than September 18, 2026.
4. The County will carry out said relocation, adjustment or installation and accurately record the
costs relative thereto in accordance with applicable rules, regulations and procedures, and the
costs paid by the County pursuant to this Agreement to the Contractor. The Owner will
complete reconnecting its lines once completion of infrastructure installation is completed.
5. Any easements needed shall be recorded after work is completed and the as-built location of
utilities is established.
6. Any easements no longer needed will be vacated after any new easements are established.
7. All records pertaining to said relocation, adjustment or installation will be retained for a period
of not less than three years after final payment.
8. The Owner agrees that any facilities relocated to a position within the Owl Creek Road right-of-
way will accommodate the usual travel on Owl Creek Road in accordance with C.R.S. Sec. 38-
5-101, C.R.S. 1973, as amended.
9. Bills for work hereunder shall be submitted to the Owner not later than 90 days after completion
of the work by the County.
10. If the County determines during the performance of the work described herein that the
estimated costs will be more than10% above the estimated amount shown in the attached
Exhibit D, the County must enter into a supplemental amendment of this Agreement with the
Owner, or obtain other appropriate authorization from the Owner in order to increase the
amount of this Agreement, before performing any work which will exceed the current estimated
cost. The County must itemize all cost increases on the final billing.
bocc.con.101.26
11. The County and Owner agree that as the Project shall be funded in whole or in part by federal
funds, this Agreement and all obligations performed and payments made hereunder are
subject to the applicable federally mandated Contract Provisions for Obligated Sponsors and
Airport Improvement Program Projects, issued on March 17, 2026, as contained in Exhibit E,
attached and incorporated herein.
12. A map of the Airport Property where the work will occur (Exhibit A), the Project Plans (Exhibit
B), Revocable Right-of-Way Permit (Exhibit C), Estimated Costs (Exhibit D), Federally
Mandated Contract Provisions (Exhibit E) are attached hereto and are hereby made a part of
this contract.
PITKIN COUNTY, COLORADO
IN WITNESS WHEREOF, the parties have executed this Contract as of the date first set out
herein above.
CONTRACTOR
Lumen Technologies, INC.
By:
Name Title
Date
MANAGER APPROVAL:AIRPORT APPROVAL:
Ryan Mahoney, Deputy County Manager Diane Jackson, Airport Director
Date Date
bocc.con.101.26
Deputy County Attorney
Jul-21-2026
Anne Marie McPhee
Airport Director
Jul-22-2026
Diane Jackson
Senior Network Implementation EngineerJason Sharpe
Jul-23-2026
Deputy County Manager
Ryan Mahoney
Jul-23-2026
2026 ENABLING
WORK LOCATIONS
ASPEN/PITKIN COUNTY AIRPORT
Exhibit A
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OWL CREEK ROAD
REVOCABLE ROW WORK PERMIT APPLICATION
76 Service Center Rd. · Aspen, CO · 81611 Permit # ______________
970.920.5390 Check # ______________
Permit Valid Until: _______________________
13a. Received from contractor 14. Revegetation/Landscaping Plan 14a. Received from contractor
Permit Fee (no refunds)$650 THIS PERMIT RESULTS IN A
REVOCABLE LICENSE
21. Surety Bonds Received and Approved by 21a. Date
11. Does Work Impact Pitkin County Open Space & Trails?
>30% Slope
Having carefully read the requirements of the below, I (permitee) hereby agree to the terms and condition described within. This
form is a permit only when validated by county staff, work started without permit will be double fee.
10. Purpose:
20. Approved by Public Works Designee 20a. Date
19. Approved by Land Management Designee
16. Construction Bond Amount $_____________ Initials_________ Bond Cert#______________________Release Date_______
6b. Lot 6c. Block 6d. Subdivision Name (if Applicable)
*>30% Slope - Applicants must go through a full development review process with the County Community Development Department for any activity that
encroaches on areas with more than a 30% slope.
8b. Phone(s)8a. Traffic Control Company
BOND REQUIREMENTS: Bonds held for 2 years and must be submitted prior to construction
9. Type of work (check all that apply):
12. Signature of Applicant Date
Permit will not be released to applicant until all required documents have been submitted (see below)
18. Special Conditions:
13. Certified Traffic Control Plan (including
dimensions)
PPERMITT NOTT VALIDD UNLESSS ALLL THREEE SIGNATURESS AREE PROVIDED
17. Revegetation Bond Amount $_____________ Initials_________ Bond Cert#______________________Release Date_______
15. Approved by Open Space & Trails Designee (pertaining to line 11) Date
19a. Date
5. Name of Project (IF ANY)
FFORR STAFFF USEE ONLYY (DOO NOTT WRITEE BELOWW THISS LINE):
7a. Description of Job
7b. Start Date: 7c. End Date
6a. Nearest Intersection6. Work Location
7d. Bond Expires (if applicable)
If there is any anticipated traffic interference on County Roads, Dispatch must be notified Each day of work 920-5310
VVALIDD PERMITT MUSTT BEE KEPTT ONN SITEE ATT ALLL TIMES
2. Contractor Name
4.Contractor Mailing Address
1. Owner's Name & Address
3. Contractor Contact Person 3b. Contact Phone(s)
YES
(
NO
yp
Fence LandscapingWall Other
YES NO
Water ____Sewer ____Repair ____Phone ____Gas ____Electric ____Other _____________________
YES NO
NOYES YESNO NO
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NO * If yes see below
?YES NO If yes Approval must be obtained and signed on line 15
Lumen Technologies, 401 Sawatch Rd, Eagle, CO 81631
Aspen/Pitkin County Airport Modernization Program - Owl Creek Road Shift
Owl Creek Road - SW corner of ASE SH 82
Relocation of HCE assets to facilitate runway and Owl Creek Road Shift
Mid-July 2026 November 1, 2026
TBD
x x
x
Kiewit Infrastructure CO. and Holy Cross Electric
Ryan Konen 970-342-8692
Exhibit C
Jul-23-2026
Permit Conditions: RR2026 - XX
General Conditions
1. These permit conditions shall apply and be binding on the applicant in addition to any other agreements between
Pitkin County and the applicant.
2. In consideration of the issuance of a revocable permit for the structure(s) above indicated, applicant agrees as
follows:
3. That the structure(s) herein are authorized on a revocable permit basis and are restricted exclusively to the land
described.
4. Permit is required to be kept on the job site during all work within the County right of way.
5. That the permit is limited specifically to the type of structure(s) described on the application.
6. That the applicant shall notify the County 2 weeks in advance of the start of construction, in order that proper
inspection may be made by the County Engineer or his representative.
7. The applicant agrees to indemnify and hold harmless the County of Pitkin, Colorado, officers, employees and
agents from and against all liability, claims and demands on account of injury, or loss or damage, including
without limitation claims arising from bodily injury, personal injury, sickness, disease, death, property loss or
damage, or any other loss of any kind whatsoever, which arise from or are in any manner connected with the
applicant's activities pursuant to this permit if such injury, loss, or damage is caused in whole or in part by the act,
omission, error, professional error, mistake, negligence or other fault of applicant, its contractor or sub-contractor.
The applicant also agrees to investigate, handle, respond to, and to provide defense from and defend against any
such liability, claims or demands at its sole expense.
8. The applicant also agrees to bear all other expenses relating thereto, including court costs and attorney's fees,
whether or not any such liability, claims or demands alleged are groundless, false or fraudulent.
9. The applicant agrees to procure and maintain at its own cost, a policy or policies of insurance sufficient to ensure
against all liability claims, demands or other obligations assumed by the applicant as set forth herein. The County
will determine the sufficiency of said insurance coverage prior to approval of this permit. The applicant further
agrees to release Pitkin County, its officers, agents and employees from any and all liability, claims, demands, or
actions or causes of actions whatsoever arising from any damage, loss or injury to the applicant or the applicant's
property, roads, roadsides, road easements, or right-of way.
10. That the permit may be revoked whenever it is determined that the structure constitutes a nuisance, destroys or
impairs the use of the right-of-way by the public, constitutes a traffic hazard, or property upon which the
encroachment, obstruction, or structure exists is required for another or added use by the public; or it may be
revoked at any time for any reason deemed sufficient by Pitkin County.
11. That the applicant will remove, at its sole expense, the structure within ten (10) calendar days of receiving written
certified notice of revocation of this permit.
12. That in the event said removal of the structure is not accomplished by the applicant within the time period
specified in Paragraph 11, Pitkin County is hereby authorized to remove same and has the right to charge and
receive payment of any and all work, materials and equipment time utilized to remove same, If applicant refuses
to pay these costs, Pitkin County has the right to make an assessment against the property and collect all costs of
removal in the same manner as general taxes are collected.
13. That the applicant agrees to perform any maintenance, including landscape maintenance to the structure(s) and
its associated impacts on the right-of-way.
14. That the applicant has read and understands all of the terms and conditions set forth in this application.
15. Permit does not represent or guarantee the location or existence of County Right of Way. It is the Contractor's
responsibility to ensure that all work is within the County Right of Way.
16. Permit issued shall pertain only to work within the County Right of Way and is in no way a Permit to enter private
property, or to alter or disturb any facilities or installation already existing within the Right of Way.
17. Any necessary easements or agreements to construct the presented design from private entities shall be
executed prior to the commencement of construction.
18. Work off of the Right of Way may be subject to additional permits from Pitkin County.
19. Permittee shall supply a weekly construction report detailing:
a. Production rates, avg time of delay, hours worked and any required testing of materials.
Traffic Control
20. Contractor is responsible for providing traffic management. Traffic control devices and the deployment shall
comply with the latest addition of Manual for Uniform Traffic Control Devices.
21. Traffic Control MHTs shall be submitted to the County at least 1 week prior to beginning of work.
22. Contractor shall work no more than 2 traffic control zones at any time unless otherwise approved by Pitkin
County.
23. Contractor shall not work on federal holidays.
24. Work shall be completed by November 1, 2026 with care that the road is clean.
25. One lane for traffic and emergency vehicles must be kept open at all times from 9:00 am to 7:00 pm with both
lanes open from 7:00 pm to 9:00 am and weekends.
26. No full road closures are allowed without prior approval. Contractor is responsible to notify Pitkin County Dispatch
(970-920-5310) prior to lane closures and after the lane has been reopened.
27. Temporary delineation of the edge line and center line will be necessary. Chip Seal tabs or approved equivalent
will be required.
Construction Requirements
28. A 5” T patch will be required for the length of the road cut. If needed.
29. All construction and backfilling shall be completed in accordance with the latest addition of the Colorado
Department of Transportation Standards Specifications for Road and Bridge Construction and the Pitkin County
Road Maintenance and Management Plan for County Roads and Right of Ways 2022.
30. Existing Utilities shall be potholed at each crossing to verify depth and horizontal location.
31. Dust suppression is required at all times. Roadways must be swept prior to completion of work daily.
32. Storage of equipment and materials shall be done in places where at least 4 feet of separation from the travel way
can be facilitated. Barrels shall be used around equipment when staged on the sides of the road.
33. Trenches shall be left backfilled at the end of each working day. If a trench cannot be backfilled, other means
such as plates must be preapproved by the County Engineer prior to use.
34. If approved Bridging Plates must be substantially bridging, properly anchored and capable of carrying the legal
limit loading, in addition to adequate trench bracing, shall be used to bridge across trenches at street crossings
where trench backfill and temporary patches have not been completed during regular working hours. Safe and
convenient passage for pedestrians and access to all properties shall be maintained.
35. The bridging plate shall be secured to the pavement with anchored pins or approved equivalent so that it does not
slip. The bridging plate shall extend over supporting pavement by a minimum of one foot (1') on all sides. Cold
mixed asphalt shall be ramped a minimum of two feet (2') in the travel direction.
36. Roadway, driveway and trail crossing shall be done in a manner so that access is maintained for the traveling
public, to driveways, and trails.
37. Road crossings shall be either bored or be up to grade at the end of each working day.
38. Contractor shall anticipate potholing existing utilities at known conflict areas.
39. Contractor shall be responsible for completion of all asphalt and concrete restoration within 15 days of the initial
cut. Contractor is responsible for maintaining road cuts by providing temporary (cold mix) until a hot mix patch can
be placed.
40. Asphalt shall be PG 58-28 grading SX and shall be compacted to CDOT specifications
41. All cuts shall be perpendicular or parallel to the roadway. Patch shall conform to the T patch exhibit sheet. Any
exceptions must have prior approval. No diagonal cuts are permitted.
42. Milled tie ins at end of overlay and any driveway, road or trail affected by the new overlay.
43. Contractor shall place a 2’ shoulder along both sides of the new 2” overlay.
44. Shoulder material shall be ABC Class 6 (¾” road base).
45. Backfill for trenches shall conform with M-603-5 or other applicable CDOT M&S Standards.
46. Trenches crossing the roadway shall be filled with ABC Class 6 (¾” road base) and compacted to 95% of Proctor
Value. Other trenches within Right of Way shall be filled with approved material and compacted to 95% of Proctor
Value.
47. Work around existing culverts and inlets to be coordinated with designated County inspector.
48. No new Permits will be issued to any contractor until work on the current permit is completed and approved by the
County.
49. Independent firms shall perform Quality Assurance and Quality Control testing for all work (trench backfill and
asphalt) within the County Right of Way with a copy of the results sent to Pitkin County.
50. If a culvert is required for any portion of the work it shall be at least 18” in diameter unless otherwise approved by
the County.
51. Utilities must be installed a minimum of 24” below roadway surface or per the utility required depth, whichever is
the greatest.
52. Any utilities or other installations that cross a culvert shall be placed a minimum of 24” below the existing culvert
or a minimum of 24” under the flow line of the existing ditch.
53. No impact allowed to culverts or facilities, any damage will result in contractor replacing or repairing culvert or
facilities.
54. Contractor shall warranty work for two years after completion of the project.
55. Permittee is responsible for obtaining all necessary private or public easements for the project.
56. No use of explosives without prior County approval.
57. Please take care to leave inlet and outlet areas in as good or better shape then found.
58. All trenching to be completed at least 3’ from guardrail or as approved in the field by the County Engineer’s
designee.
59. Any condition changes to the above-mentioned standards shall require prior approval by the County Engineer or
his designee.
Revegetation/ Reclamation
1. Contractor shall warranty the revegetation for two growing seasons.
2. Contractor shall re-seed to Pitkin County standards in the Revegetation guide.
3. The Contractor is responsible for the success of the revegetation. If desired, the County reserves the option to
hire a third-party monitor at the sole expense of the contractor, to perform Quality Assurance and Quality Control
testing for all revegetation performed on County property and within the County Right of Way with a copy of the
results sent to Pitkin County.
Line Item Line Item Description QTY UNIT Kiewit Unit Price Total Cost
13-002
Remove Existing Underground Lumen
Fiber Line 1360.00 LF 27.57$ 37,489.57$
13-003
Remove Existing Underground Lumen
Copper Comm Line 1830.00 LF 27.49$ 50,303.82$
13-006 Remove Existing Lumen Manhole 2.00 LF 4,187.84$ 8,375.68$
13-010
Remove Existing Lumen Comm
Pedestal Equipment Pad 1.00 EA 5,356.90$ 5,356.90$
13-011
203 - Common Utility Trench (Holy
Cross Electric Line,
Lumen 24 Strand Fiber, Lumen 100 1.00 EA 212,843.78$ 212,843.78$
13-014
Install New Lumen Equipment Pad
(Fiber Pedestal)1.00 EA 8,389.87$ 8,389.87$
13-016
Install New Lumen Manhole - not
handhold 2.00 EA 4,783.81$ 9,567.62$
Lumen 1 Install/Pull New Fiber Per Plan Lumen Cost
Lumen 2 Splice New Fiber Per Lumen Plan Lumen Cost
Lumen 3 Vaults and appurtenances Per Plan Lumen Cost
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Exhibit D
EXHIBIT D
FEDERAL CONTRACT PROVISIONS FOR OBLIGATED SPONSORS AND
AIRPORT PROGRAM PROJECTS
I. ACCESS TO RECORDS AND REPORTS
The Contractor must maintain an acceptable cost accounting system. The Contractor agrees to provide
the Owner, the Federal Aviation Administration and the Comptroller General of the United States or
any of their duly authorized representatives access to any books, documents, papers and records of
the Contractor which are directly pertinent to the specific contract for the purpose of making audit,
examination, excerpts and transcriptions. The Contractor agrees to maintain all books, records and
reports required under this contract for a period of not less than three years after final payment is
made and all pending matters are closed.
II. BREACH OF CONTRACT TERMS
Any violation or breach of terms of this contract on the part of the Contractor or its subcontractors
may result in the suspension or termination of this contract or such other action that may be necessary
to enforce the rights of the parties of this agreement.
Owner will provide Contractor written notice that describes the nature of the breach and corrective
actions the Contractor must undertake in order to avoid termination of the contract. Owner reserves
the right to withhold payments to Contractor until such time the Contractor corrects the breach or the
Owner elects to terminate the contract. The Owner’s notice will identify a specific date by which the
Contractor must correct the breach. Owner may proceed with termination of the contract if the
Contractor fails to correct the breach by the deadline indicated in the Owner’s notice.
The duties and obligations imposed by the Contract Documents and the rights and remedies available
thereunder are in addition to, and not a limitation of, any duties, obligations, rights and remedies
otherwise imposed or available by law.
III. FAA BUY AMERICAN PREFERENCE
The Contractor certifies that its bid/offer is in compliance with 49 U.S.C. § 50101, BABA and other
related Made in America Laws,1 U.S. statutes, guidance, and FAA policies, which provide that Federal
funds may not be obligated unless all iron, steel and manufactured goods used in AIP funded projects
are produced in the United States, unless the Federal Aviation Administration has issued a waiver for
1 Per Executive Order 14005 “Made in America Laws” means all statutes, regulations, rules, and Executive Orders
relating to federal financial assistance awards or federal procurement, including those that refer to “Buy America” or
“Buy American,” that require, or provide a preference for, the purchase or acquisition of goods, products, or
materials produced in the United States, including iron, steel, and manufactured products offered in the United
States.
E
the product; the product is listed as an Excepted Article, Material Or Supply in Federal Acquisition
Regulation subpart 25.108; or is included in the FAA Nationwide Buy American Waivers Issued list.
The bidder or offeror must complete and submit the certification of compliance with FAA’s Buy
American Preference, BABA and Made in America laws included herein with their bid or offer. The
Airport Sponsor/Owner will reject as nonresponsive any bid or offer that does not include a completed
certification of compliance with FAA’s Buy American Preference and BABA.
The bidder or offeror certifies that all constructions materials, defined to mean an article, material, or
supply other than an item of primarily iron or steel; a manufactured product; cement and cementitious
materials; aggregates such as stone, sand, or gravel; or aggregate binding agents or additives that are
or consist primarily of: non-ferrous metals; plastic and polymer-based products (including
polyvinylchloride, composite building materials, and polymers used in fiber optic cables); glass
(including optic glass); lumber; or drywall used in the project are manufactured in the U.S.
The bidder or offeror certifies procurement of certain rolling stock using FAA grant funds will prohibit
airports from using Federal financial assistance to procure buses or rail car vehicle rolling stock from
covered entities.
Certification of Compliance with FAA Buy American Preference – Construction
Projects
As a matter of bid responsiveness, the bidder or offeror must complete, sign, date, and submit this
certification statement with its proposal. The bidder or offeror must indicate how it intends to comply
with 49 U.S.C. § 50101, BABA and other related Made in America Laws, U.S. statutes, guidance, and
FAA policies, by selecting one of the following certification statements. These statements are mutually
exclusive. Bidder must select one or the other (i.e., not both) by inserting a checkmark (ü) or the letter
“X”.
Bidder or offeror hereby certifies that it will comply with 49 U.S.C. § 50101, BABA and other
related U.S. statutes, guidance, and policies of the FAA by:
a) Only installing iron, steel and manufactured products produced in the United States;
b) Only installing construction materials defined as: an article, material, or supply – other
than an item of primarily iron or steel; a manufactured product; cement and
cementitious materials; aggregates such as stone, sand, or gravel; or aggregate binding
agents or additives that are or consist primarily of non-ferrous metals; plastic and
polymer-based products (including polyvinylchloride, composite building materials, and
polymers used in fiber optic cables); glass (including optic glass); lumber or drywall that
have been manufactured in the United States.
c) Installing manufactured products for which the Federal Aviation Administration (FAA)
has issued a waiver as indicated by inclusion on the current FAA Nationwide Buy
American Waivers Issued listing; or
d) Installing products listed as an Excepted Article, Material or Supply in Federal
Acquisition Regulation Subpart 25.108.
X
By selecting this certification statement, the bidder or offeror agrees:
a) To provide to the Airport Sponsor or the FAA evidence that documents the source and
origin of the iron, steel, and/or manufactured product.
b) To faithfully comply with providing U.S. domestic products.
c) To refrain from seeking a waiver request after establishment of the contract, unless
extenuating circumstances emerge that the FAA determines justified.
d) Certify that all construction materials used in the project are manufactured in the U.S.
The bidder or offeror hereby certifies it cannot comply with the 100 percent Buy American
Preferences of 49 U.S.C. § 50101(a) but may qualify for a Type 3 or Type 4 waiver under 49 USC
§ 50101(b). By selecting this certification statement, the apparent bidder or offeror with the
apparent low bid agrees:
a) To the submit to the Airport Sponsor or FAA within 15 calendar days of being selected as
the responsive bidder, a formal waiver request and required documentation that
supports the type of waiver being requested.
b) That failure to submit the required documentation within the specified timeframe is
cause for a non-responsive determination that may result in rejection of the proposal.
c) To faithfully comply with providing U.S. domestic products at or above the approved
U.S. domestic content percentage as approved by the FAA.
d) To furnish U.S. domestic product for any waiver request that the FAA rejects.
e) To refrain from seeking a waiver request after establishment of the contract, unless
extenuating circumstances emerge that the FAA determines justified.
Required Documentation
Type 2 Waiver (Nonavailability) - The iron, steel, manufactured goods or construction materials or
manufactured goods are not available in sufficient quantity or quality in the United States. The
required documentation for the Nonavailability waiver is
a) Completed Content Percentage Worksheet and Final Assembly Questionnaire
b) Record of thorough market research, consideration where appropriate of qualifying alternate
items, products, or materials including;
c) A description of the market research activities and methods used to identify domestically
manufactured items capable of satisfying the requirement, including the timing of the research
and conclusions reached on the availability of sources.
Type 3 Waiver – The cost of components and subcomponents produced in the United States is more
than 60 percent of the cost of all components and subcomponents of the “facility/project.” The
required documentation for a Type 3 waiver is:
a) Completed Content Percentage Worksheet and Final Assembly Questionnaire including;
b) Listing of all manufactured products that are not comprised of 100 percent U.S. domestic
content (excludes products listed on the FAA Nationwide Buy American Waivers Issued listing
and products excluded by Federal Acquisition Regulation Subpart 25.108; products of unknown
origin must be considered as non-domestic products in their entirety).
c) Cost of non-domestic components and subcomponents, excluding labor costs associated with
final assembly and installation at project location.
d) Percentage of non-domestic component and subcomponent cost as compared to total “facility”
component and subcomponent costs, excluding labor costs associated with final assembly and
installation at project location.
Type 4 Waiver (Unreasonable Costs) - Applying this provision for iron, steel, manufactured goods or
construction materials would increase the cost of the overall project by more than 25 percent. The
required documentation for this waiver is:
a) A completed Content Percentage Worksheet and Final Assembly Questionnaire from
b) At minimum two comparable equal bids and/or offers;
c) Receipt or record that demonstrates that supplier scouting called for in Executive Order 14005,
indicates that no domestic source exists for the project and/or component;
d) Completed waiver applications for each comparable bid and/or offer.
False Statements: Per 49 USC § 47126, this certification concerns a matter within the jurisdiction of
the Federal Aviation Administration and the making of a false, fictitious, or fraudulent certification
may render the maker subject to prosecution under Title 18, United States Code.
Date Signature
Company Name Title
Senior Network Implementation Engineer
Jul-23-2026
Lumen
IV. GENERAL CIVIL RIGHTS PROVISIONS
In all its activities within the scope of its airport program, the Contractor agrees to comply with
pertinent statutes, Executive Orders, and such rules as identified in Title VI List of Pertinent
Nondiscrimination Acts and Authorities to ensure that no person shall, on the grounds of race, color,
national origin, creed, sex, age, or disability be excluded from participating in any activity conducted
with or benefiting from Federal assistance.
This provision is in addition to that required by Title VI of the Civil Rights Act of 1964.
The above provision binds the Contractor and subcontractors from the bid solicitation period through
the completion of the contract.
V. CIVIL RIGHTS – TITLE VI ASSURANCE
Title VI Solicitation Notice:
The (Title of Recipient), in accordance with the provisions of Title VI of the Civil Rights Act of 1964 (78
Stat. 252, 42 U.S.C. §§ 2000d to 2000d-4), 28 CFR § 50.3, and 49 CFR Part 21, hereby notifies all bidders
that it will affirmatively ensure that any contract entered into pursuant to this advertisement, all
contractors will be afforded full opportunity to submit bids in response to this invitation and will not be
discriminated against on the grounds of the owner’s race, color, national origin, sex, creed, age, or
disability in consideration for an award.
Title VI List of Pertinent Nondiscrimination Acts and Authorities
During the performance of this contract, the Contractor, for itself, its assignees, and successors in
interest (hereinafter referred to as the “Contractor”) agrees to comply with the following non-
discrimination statutes and authorities; including but not limited to:
• Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000d et seq., 78 stat. 252) (prohibits
discrimination on the basis of race, color, national origin);
• 49 CFR Part 21 (Non-discrimination in Federally-Assisted programs of the Department of
Transportation—Effectuation of Title VI of the Civil Rights Act of 1964) including amendments
thereto;
• The Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, (42 U.S.C.
§ 4601) (prohibits unfair treatment of persons displaced or whose property has been acquired
because of Federal or Federal-aid programs and projects);
• Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. § 794 et seq.), as amended (prohibits
discrimination on the basis of disability); and 49 CFR part 27 (Nondiscrimination on the Basis of
Disability in Programs or Activities Receiving Federal Financial Assistance);
• The Age Discrimination Act of 1975, as amended (42 .U.S.C. § 6101 et seq.) (prohibits
discrimination on the basis of age);
• Airport and Airway Improvement Act of 1982 (49 U.S.C. § 47123), as amended (prohibits
discrimination based on race, creed, color, national origin, or sex);
• The Civil Rights Restoration Act of 1987 (P.L. 100-259) (broadened the scope, coverage and
applicability of Title VI of the Civil Rights Act of 1964, the Age Discrimination Act of 1975 and
Section 504 of the Rehabilitation Act of 1973, by expanding the definition of the terms
“programs or activities” to include all of the programs or activities of the Federal-aid recipients,
sub-recipients and contractors, whether such programs or activities are Federally funded or
not);
• Titles II and III of the Americans with Disabilities Act of 1990 (42 U.S.C. § 12101, et seq) (prohibit
discrimination on the basis of disability in the operation of public entities, public and private
transportation systems, places of public accommodation, and certain testing entities) as
implemented by U.S. Department of Transportation regulations at 49 CFR Parts 37 and 38;
• Title IX of the Education Amendments of 1972, as amended, which prohibits you from
discriminating because of sex in education programs or activities (20 U.S.C. § 1681, et seq).
Compliance with Nondiscrimination Requirements:
During the performance of this contract, the Contractor, for itself, its assignees, and successors in
interest (hereinafter referred to as the “Contractor”), agrees as follows:
1. Compliance with Regulations: The Contractor (hereinafter includes consultants) will comply
with the Title VI List of Pertinent Nondiscrimination Acts and Authorities, as they may be
amended from time to time, which are herein incorporated by reference and made a part of
this contract.
2. Nondiscrimination: The Contractor, with regard to the work performed by it during the
contract, will not discriminate on the grounds of race, color, national origin), creed, sex, age,
or disability in the selection and retention of subcontractors, including procurements of
materials and leases of equipment. The Contractor will not participate directly or indirectly
in the discrimination prohibited by the Nondiscrimination Acts and Authorities, including
employment practices when the contract covers any activity, project, or program set forth in
Appendix B of 49 CFR part 21 including amendments thereto.
3. Solicitations for Subcontracts, including Procurements of Materials and Equipment: In all
solicitations, either by competitive bidding or negotiation made by the Contractor for work
to be performed under a subcontract, including procurements of materials, or leases of
equipment, each potential subcontractor or supplier will be notified by the Contractor of the
contractor’s obligations under this contract and the Nondiscrimination Acts and Authorities
on the grounds of race, color, or national origin.
4. Information and Reports: The Contractor will provide all information and reports required
by the Acts, the Regulations, and directives issued pursuant thereto and will permit access
to its books, records, accounts, other sources of information, and its facilities as may be
determined by the Sponsor or the Federal Aviation Administration to be pertinent to
ascertain compliance with such Nondiscrimination Acts and Authorities and instructions.
Where any information required of a contractor is in the exclusive possession of another
who fails or refuses to furnish the information, the Contractor will so certify to the Sponsor
or the Federal Aviation Administration, as appropriate, and will set forth what efforts it has
made to obtain the information.
5. Sanctions for Noncompliance: In the event of a Contractor’s noncompliance with the non-
discrimination provisions of this contract, the Sponsor will impose such contract sanctions as
it or the Federal Aviation Administration may determine to be appropriate, including, but
not limited to:
a. Withholding payments to the Contractor under the contract until the Contractor
complies; and/or
b. Cancelling, terminating, or suspending a contract, in whole or in part.
6. Incorporation of Provisions: The Contractor will include the provisions of paragraphs one
through six in every subcontract, including procurements of materials and leases of
equipment, unless exempt by the Acts, the Regulations, and directives issued pursuant
thereto. The Contractor will take action with respect to any subcontract or procurement as
the Sponsor or the Federal Aviation Administration may direct as a means of enforcing such
provisions including sanctions for noncompliance. Provided, that if the Contractor becomes
involved in, or is threatened with litigation by a subcontractor, or supplier because of such
direction, the Contractor may request the Sponsor to enter into any litigation to protect the
interests of the Sponsor. In addition, the Contractor may request the United States to enter
into the litigation to protect the interests of the United States.
CLAUSES FOR CONSTRUCTION/USE/ACCESS TO REAL PROPERTY ACQUIRED
UNDER THE ACTIVITY, FACILITY OR PROGRAM
The following clauses will be included in deeds, licenses, permits, or similar instruments/agreements
entered into by (Title of Sponsor) pursuant to the provisions of the Airport Improvement Program
grant assurances.
A. The (grantee, licensee, permittee, etc., as appropriate) for himself/herself, his/her heirs,
personal representatives, successors in interest, and assigns, as a part of the consideration
hereof, does hereby covenant and agree (in the case of deeds and leases add, “as a
covenant running with the land”) that (1) no person on the ground of race, color, or national
origin, will be excluded from participation in, denied the benefits of, or be otherwise
subjected to discrimination in the use of said facilities, (2) that in the construction of any
improvements on, over, or under such land, and the furnishing of services thereon, no
person on the ground of race, color, or national origin, will be excluded from participation
in, denied the benefits of, or otherwise be subjected to discrimination, (3) that the (grantee,
licensee, lessee, permittee, etc.) will use the premises in compliance with all other
requirements imposed by or pursuant to the Title VI List of Pertinent Nondiscrimination Acts
and Authorities.
B. With respect to (licenses, leases, permits, etc.), in the event of breach of any of the above
Non-discrimination covenants, (Title of Sponsor) will have the right to terminate the
(license, permit, etc., as appropriate) and to enter or re-enter and repossess said land and
the facilities thereon, and hold the same as if said (license, permit, etc., as appropriate) had
never been made or issued.*
C. With respect to deeds, in the event of breach of any of the above Non-discrimination
covenants, (Title of Sponsor) will there upon revert to and vest in and become the absolute
property of (Title of Sponsor) and its assigns.
VI. CLEAN AIR AND WATER POLLUTION CONTROL
Contractor agrees to comply with all applicable standards, orders, and regulations issued pursuant to
the Clean Air Act (42 U.S.C. §§ 7401-7671q) and the Federal Water Pollution Control Act as amended
(33 U.S.C. §§ 1251-1387). The Contractor agrees to report any violation to the Owner immediately
upon discovery. The Owner assumes responsibility for notifying the Environmental Protection Agency
(EPA) and the Federal Aviation Administration.
Contractor must include this requirement in all subcontracts that exceed $150,000.
VII. CONTRACT WORKHOURS AND SAFETY STANDARDS ACT REQUIREMENTS
1. Overtime Requirements.
No contractor or subcontractor contracting for any part of the contract work which may require or
involve the employment of laborers or mechanics shall require or permit any such laborer or
mechanic, including watchmen and guards, in any workweek in which he or she is employed on such
work to work in excess of forty hours in such workweek unless such laborer or mechanic receives
compensation at a rate not less than one and one-half times the basic rate of pay for all hours worked
in excess of forty hours in such workweek.
2. Violation; Liability for Unpaid Wages; Liquidated Damages.
In the event of any violation of the clause set forth in paragraph (1) of this clause, the Contractor and
any subcontractor responsible therefore shall be liable for the unpaid wages. In addition, such
contractor and subcontractor shall be liable to the United States (in the case of work done under
contract for the District of Columbia or a territory, to such District or to such territory), for liquidated
damages. Such liquidated damages shall be computed with respect to each individual laborer or
mechanic, including watchmen and guards, employed in violation of the clause set forth in paragraph
(1) of this clause, in the sum of $33 for each calendar day on which such individual was required or
permitted to work in excess of the standard workweek of forty hours without payment of the overtime
wages required by the clause set forth in paragraph (1) of this clause.
3. Withholding for Unpaid Wages and Liquidated Damages.
The Federal Aviation Administration (FAA) or the Owner shall upon its own action or upon written
request of an authorized representative of the Department of Labor withhold or cause to be withheld,
from any moneys payable on account of work performed by the contractor or subcontractor under any
such contract or any other Federal contract with the same prime contractor, or any other federally-
assisted contract subject to the Contract Work Hours and Safety Standards Act, which is held by the
same prime contractor, such sums as may be determined to be necessary to satisfy any liabilities of
such contractor or subcontractor for unpaid wages and liquidated damages as provided in the clause
set forth in paragraph (2) of this clause.
4. Subcontractors.
The Contractor or subcontractor shall insert in any subcontracts the clauses set forth in paragraphs (1)
through (4) and also a clause requiring the subcontractor to include these clauses in any lower tier
subcontracts. The prime contractor shall be responsible for compliance by any subcontractor or lower
tier subcontractor with the clauses set forth in paragraphs (1) through (4) of this clause.
VIII. COPELAND “ANTI-KICKBACK” ACT
Contractor must comply with the requirements of the Copeland “Anti-Kickback” Act (18 USC 874 and
40 USC 3145), as supplemented by Department of Labor regulation 29 CFR part 3. Contractor and
subcontractors are prohibited from inducing, by any means, any person employed on the project to
give up any part of the compensation to which the employee is entitled. The Contractor and each
Subcontractor must submit to the Owner, a weekly statement on the wages paid to each employee
performing on covered work during the prior week. Owner must report any violations of the Act to the
Federal Aviation Administration.
IX. DAVIS-BACON REQUIREMENTS
1. Minimum Wages.
(i) All laborers and mechanics employed or working upon the site of the work will be paid
unconditionally and not less often than once a week, and without subsequent deduction or rebate on
any account (except such payroll deductions as are permitted by the Secretary of Labor under
regulations implementing the Copeland Act (29 CFR Part 3)), the full amount of wages and bona fide
fringe benefits (or cash equivalent thereof) due at time of payment computed at rates not less than
those contained in the wage determination of the Secretary of Labor which is attached hereto and
made a part hereof, regardless of any contractual relationship which may be alleged to exist between
the Contractor and such laborers and mechanics.
Contributions made or costs reasonably anticipated for bona fide fringe benefits under section 1(b)(2)
of the Davis-Bacon Act on behalf of laborers or mechanics are considered wages paid to such laborers
or mechanics, subject to the provisions of paragraph (1)(iv) of this section; also, regular contributions
made or costs incurred for more than a weekly period (but not less often than quarterly) under plans,
funds, or programs which cover the particular weekly period, are deemed to be constructively made or
incurred during such weekly period. Such laborers and mechanics shall be paid the appropriate wage
rate and fringe benefits on the wage determination for the classification of work actually performed,
without regard to skill, except as provided in 29 CFR § 5.5(a)(4). Laborers or mechanics performing
work in more than one classification may be compensated at the rate specified for each classification
for the time actually worked therein: Provided, that the employer’s payroll records accurately set forth
the time spent in each classification in which work is performed. The wage determination (including
any additional classification and wage rates conformed under (1)(ii) of this section) and the Davis-
Bacon poster (WH-1321) shall be posted at all times by the Contractor and its subcontractors at the
site of the work in a prominent and accessible place where it can easily be seen by the workers.
(ii)(A) The contracting officer shall require that any class of laborers or mechanics, including helpers,
which is not listed in the wage determination and which is to be employed under the contract shall be
classified in conformance with the wage determination. The contracting officer shall approve an
additional classification and wage rate and fringe benefits therefore only when the following criteria
have been met:
(1) The work to be performed by the classification requested is not performed by a classification in the
wage determination;
(2) The classification is utilized in the area by the construction industry; and
(3) The proposed wage rate, including any bona fide fringe benefits, bears a reasonable relationship to
the wage rates contained in the wage determination.
(B) If the Contractor and the laborers and mechanics to be employed in the classification (if known), or
their representatives, and the contracting officer agree on the classification and wage rate (including
the amount designated for fringe benefits where appropriate), a report of the action taken shall be
sent by the contracting officer to the Administrator of the Wage and Hour Division, U.S. Department of
Labor, Washington, DC 20210. The Administrator, or an authorized representative, will approve,
modify, or disapprove every additional classification action within 30 days of receipt and so advise the
contracting officer or will notify the contracting officer within the 30-day period that additional time is
necessary.
(C) In the event the Contractor, the laborers, or mechanics to be employed in the classification, or their
representatives, and the contracting officer do not agree on the proposed classification and wage rate
(including the amount designated for fringe benefits, where appropriate), the contracting officer shall
refer the questions, including the views of all interested parties and the recommendation of the
contracting officer, to the Administrator for determination. The Administrator, or an authorized
representative, will issue a determination within 30 days of receipt and so advise the contracting
officer or will notify the contracting officer within the 30-day period that additional time is necessary.
(D) The wage rate (including fringe benefits where appropriate) determined pursuant to
subparagraphs (1)(ii) (B) or (C) of this paragraph, shall be paid to all workers performing work in the
classification under this contract from the first day on which work is performed in the classification.
(iii) Whenever the minimum wage rate prescribed in the contract for a class of laborers or mechanics
includes a fringe benefit which is not expressed as an hourly rate, the contractor shall either pay the
benefit as stated in the wage determination or shall pay another bona fide fringe benefit or an hourly
cash equivalent thereof.
(iv) If the Contractor does not make payments to a trustee or other third person, the Contractor may
consider as part of the wages of any laborer or mechanic the amount of any costs reasonably
anticipated in providing bona fide fringe benefits under a plan or program, Provided, that the Secretary
of Labor has found, upon the written request of the Contractor, that the applicable standards of the
Davis-Bacon Act have been met. The Secretary of Labor may require the Contractor to set aside in a
separate account assets for the meeting of obligations under the plan or program.
2. Withholding. The Federal Aviation Administration or the Sponsor shall upon its own action or upon
written request of an authorized representative of the Department of Labor withhold or cause to be
withheld from the Contractor under this contract or any other Federal contract with the same prime
contractor, or any other federally-assisted contract subject to Davis-Bacon prevailing wage
requirements, which is held by the same prime contractor, so much of the accrued payments or
advances as may be considered necessary to pay laborers and mechanics, including apprentices,
trainees, and helpers, employed by the Contractor or any subcontractor the full amount of wages
required by the contract. In the event of failure to pay any laborer or mechanic, including any
apprentice, trainee, or helper, employed or working on the site of the work, all or part of the wages
required by the contract, the Federal Aviation Administration may, after written notice to the
Contractor, Sponsor, Applicant, or Owner, take such action as may be necessary to cause the
suspension of any further payment, advance, or guarantee of funds until such violations have ceased.
3. Payrolls and Basic Records.
(i) Payrolls and basic records relating thereto shall be maintained by the Contractor during the course
of the work and preserved for a period of three years thereafter for all laborers and mechanics
working at the site of the work. Such records shall contain the name, address, and social security
number of each such worker; his or her correct classification; hourly rates of wages paid (including
rates of contributions or costs anticipated for bona fide fringe benefits or cash equivalents thereof of
the types described in 1(b)(2)(B) of the Davis-Bacon Act); daily and weekly number of hours worked;
deductions made; and actual wages paid. Whenever the Secretary of Labor has found under 29 CFR
5.5(a)(1)(iv) that the wages of any laborer or mechanic include the amount of any costs reasonably
anticipated in providing benefits under a plan or program described in section 1(b)(2)(B) of the Davis-
Bacon Act, the Contractor shall maintain records that show that the commitment to provide such
benefits is enforceable, that the plan or program is financially responsible, and that the plan or
program has been communicated in writing to the laborers or mechanics affected, and records which
show the costs anticipated or the actual costs incurred in providing such benefits. Contractors
employing apprentices or trainees under approved programs shall maintain written evidence of the
registration of apprenticeship programs and certification of trainee programs, the registration of the
apprentices and trainees, and the ratios and wage rates prescribed in the applicable programs.
(ii)(A) The Contractor shall submit weekly for each week in which any contract work is performed a
copy of all payrolls to the Federal Aviation Administration if the agency is a party to the contract, but if
the agency is not such a party, the Contractor will submit the payrolls to the applicant, Sponsor, or
Owner, as the case may be, for transmission to the Federal Aviation Administration. The payrolls
submitted shall set out accurately and completely all of the information required to be maintained
under 29 CFR § 5.5(a)(3)(i), except that full social security numbers and home addresses shall not be
included on weekly transmittals. Instead, the payrolls shall only need to include an individually
identifying number for each employee (e.g., the last four digits of the employee’s social security
number). The required weekly payroll information may be submitted in any form desired. Optional
Form WH–347 is available for this purpose from the Wage and Hour Division Web site at
https://www.dol.gov/agencies/whd/government-contracts/construction/payroll-certification or its
successor site. The prime contractor is responsible for the submission of copies of payrolls by all
subcontractors. Contractors and subcontractors shall maintain the full social security number and
current address of each covered worker and shall provide them upon request to the Federal Aviation
Administration if the agency is a party to the contract, but if the agency is not such a party, the
Contractor will submit them to the applicant, Sponsor, or Owner, as the case may be, for transmission
to the Federal Aviation Administration, the Contractor, or the Wage and Hour Division of the
Department of Labor for purposes of an investigation or audit of compliance with prevailing wage
requirements. It is not a violation of this section for a prime contractor to require a subcontractor to
provide addresses and social security numbers to the prime contractor for its own records, without
weekly submission to the sponsoring government agency (or the applicant, Sponsor, or Owner).
(B) Each payroll submitted shall be accompanied by a "Statement of Compliance," signed by the
Contractor or subcontractor or his or her agent who pays or supervises the payment of the persons
employed under the contract and shall certify the following:
(1) That the payroll for the payroll period contains the information required to be provided under 29
CFR § 5.5(a)(3)(ii), the appropriate information is being maintained under 29 CFR § 5.5 (a)(3)(i), and
that such information is correct and complete;
(2) That each laborer and mechanic (including each helper, apprentice, and trainee) employed on the
contract during the payroll period has been paid the full weekly wages earned, without rebate, either
directly or indirectly, and that no deductions have been made either directly or indirectly from the full
wages earned, other than permissible deductions as set forth in Regulations, 29 CFR Part 3;
(3) That each laborer or mechanic has been paid not less than the applicable wage rates and fringe
benefits or cash equivalents for the classification of work performed, as specified in the applicable
wage determination incorporated into the contract.
(C) The weekly submission of a properly executed certification set forth on the reverse side of Optional
Form WH-347 shall satisfy the requirement for submission of the “Statement of Compliance” required
by paragraph (3)(ii)(B) of this section.
(D) The falsification of any of the above certifications may subject the Contractor or subcontractor to
civil or criminal prosecution under Section 1001 of Title 18 and Section 231 of Title 31 of the United
States Code.
(iii) The Contractor or subcontractor shall make the records required under paragraph (3)(i) of this
section available for inspection, copying, or transcription by authorized representatives of the Sponsor,
the Federal Aviation Administration, or the Department of Labor and shall permit such representatives
to interview employees during working hours on the job. If the Contractor or subcontractor fails to
submit the required records or to make them available, the Federal agency may, after written notice to
the Contractor, Sponsor, applicant, or Owner, take such action as may be necessary to cause the
suspension of any further payment, advance, or guarantee of funds. Furthermore, failure to submit the
required records upon request or to make such records available may be grounds for debarment
action pursuant to 29 CFR § 5.12.
4. Apprentices and Trainees.
(i) Apprentices. Apprentices will be permitted to work at less than the predetermined rate for the work
they performed when they are employed pursuant to and individually registered in a bona fide
apprenticeship program registered with the U.S. Department of Labor, Employment and Training
Administration, Office of Apprenticeship Training, Employer and Labor Services, or with a State
Apprenticeship Agency recognized by the Office, or if a person is employed in his or her first 90 days of
probationary employment as an apprentice in such an apprenticeship program, who is not individually
registered in the program, but who has been certified by the Office of Apprenticeship Training,
Employer and Labor Services or a State Apprenticeship Agency (where appropriate) to be eligible for
probationary employment as an apprentice. The allowable ratio of apprentices to journeymen on the
job site in any craft classification shall not be greater than the ratio permitted to the contractor as to
the entire work force under the registered program. Any worker listed on a payroll at an apprentice
wage rate, who is not registered or otherwise employed as stated above, shall be paid not less than
the applicable wage rate on the wage determination for the classification of work actually performed.
In addition, any apprentice performing work on the job site in excess of the ratio permitted under the
registered program shall be paid not less than the applicable wage rate on the wage determination for
the work actually performed. Where a contractor is performing construction on a project in a locality
other than that in which its program is registered, the ratios and wage rates (expressed in percentages
of the journeyman’s hourly rate) specified in the Contractor’s or subcontractor’s registered program
shall be observed. Every apprentice must be paid at not less than the rate specified in the registered
program for the apprentice’s level of progress, expressed as a percentage of the journeymen hourly
rate specified in the applicable wage determination. Apprentices shall be paid fringe benefits in
accordance with the provisions of the apprenticeship program. If the apprenticeship program does not
specify fringe benefits, apprentices must be paid the full amount of fringe benefits listed on the wage
determination for the applicable classification. If the Administrator determines that a different
practice prevails for the applicable apprentice classification, fringes shall be paid in accordance with
that determination. In the event the Office of Apprenticeship Training, Employer and Labor Services, or
a State Apprenticeship Agency recognized by the Office, withdraws approval of an apprenticeship
program, the Contractor will no longer be permitted to utilize apprentices at less than the applicable
predetermined rate for the work performed until an acceptable program is approved.
(ii) Trainees. Except as provided in 29 CFR § 5.16, trainees will not be permitted to work at less than
the predetermined rate for the work performed unless they are employed pursuant to and individually
registered in a program which has received prior approval, evidenced by formal certification by the
U.S. Department of Labor, Employment and Training Administration. The ratio of trainees to
journeymen on the job site shall not be greater than permitted under the plan approved by the
Employment and Training Administration. Every trainee must be paid at no less than the rate specified
in the approved program for the trainee’s level of progress, expressed as a percentage of the
journeyman hourly rate specified in the applicable wage determination. Trainees shall be paid fringe
benefits in accordance with the provisions of the trainee program. If the trainee program does not
mention fringe benefits, trainees shall be paid the full amount of fringe benefits listed on the wage
determination unless the Administrator of the Wage and Hour Division determines that there is an
apprenticeship program associated with the corresponding journeyman wage rate on the wage
determination that provides for less than full fringe benefits for apprentices. Any employee listed on
the payroll at a trainee rate that is not registered and participating in a training plan approved by the
Employment and Training Administration shall be paid not less than the applicable wage rate on the
wage determination for the classification of work actually performed. In addition, any trainee
performing work on the job site in excess of the ratio permitted under the registered program shall be
paid not less than the applicable wage rate on the wage determination for the work actually
performed. In the event the Employment and Training Administration withdraws approval of a
training program, the Contractor will no longer be permitted to utilize trainees at less than the
applicable predetermined rate for the work performed until an acceptable program is approved.
5. Compliance with Copeland Act Requirements.
The Contractor shall comply with the requirements of 29 CFR Part 3, which are incorporated by
reference in this contract.
6. Subcontracts.
The Contractor or subcontractor shall insert in any subcontracts the clauses contained in 29 CFR
§§ 5.5(a)(1) through (10) and such other clauses as the Federal Aviation Administration may by
appropriate instructions require, and also a clause requiring the subcontractors to include these
clauses in any lower tier subcontracts. The prime contractor shall be responsible for compliance by
any subcontractor or lower tier subcontractor with all the contract clauses in 29 CFR § 5.5.
7. Contract Termination: Debarment.
A breach of the contract clauses in paragraph 1 through 10 of this section may be grounds for
termination of the contract, and for debarment as a contractor and a subcontractor as provided in 29
CFR § 5.12.
8. Compliance with Davis-Bacon and Related Act Requirements.
All rulings and interpretations of the Davis-Bacon and Related Acts contained in 29 CFR Parts 1, 3, and
5 are herein incorporated by reference in this contract.
9. Disputes Concerning Labor Standards.
Disputes arising out of the labor standards provisions of this contract shall not be subject to the
general disputes clause of this contract. Such disputes shall be resolved in accordance with the
procedures of the Department of Labor set forth in 29 CFR Parts 5, 6, and 7. Disputes within the
meaning of this clause include disputes between the Contractor (or any of its subcontractors) and the
contracting agency, the U.S. Department of Labor, or the employees or their representatives.
10. Certification of Eligibility.
(i) By entering into this contract, the Contractor certifies that neither it (nor he or she) nor any person
or firm who has an interest in the Contractor’s firm is a person or firm ineligible to be awarded
Government contracts by virtue of section 3(a) of the Davis-Bacon Act or 29 CFR § 5.12(a)(1).
(ii) No part of this contract shall be subcontracted to any person or firm ineligible for award of a
Government contract by virtue of section 3(a) of the Davis-Bacon Act or 29 CFR § 5.12(a)(1).
(iii) The penalty for making false statements is prescribed in the U.S. Criminal Code, 18 USC § 1001.
X. DEBARMENT AND SUSPENSION
CERTIFICATION OF OFFEROR/BIDDER REGARDING DEBARMENT
By submitting a bid/proposal under this solicitation, the bidder or offeror certifies that neither it nor its
principals are presently debarred or suspended by any Federal department or agency from
participation in this transaction.
CERTIFICATION OF LOWER TIER CONTRACTORS REGARDING DEBARMENT
The successful bidder, by administering each lower tier subcontract that exceeds $25,000 as a
“covered transaction”, must confirm each lower tier participant of a “covered transaction” under the
project is not presently debarred or otherwise disqualified from participation in this federally-assisted
project. The successful bidder will accomplish this by:
1. Checking the System for Award Management at website: http://www.sam.gov.
2. Collecting a certification statement similar to the Certification of Offeror /Bidder Regarding
Debarment, above.
3. Inserting a clause or condition in the covered transaction with the lower tier contract.
If the Federal Aviation Administration later determines that a lower tier participant failed to disclose to
a higher tier participant that it was excluded or disqualified at the time it entered the covered
transaction, the FAA may pursue any available remedies, including suspension and debarment of the
non-compliant participant.
XI. DISADVANTAGED BUSINESS ENTERPRISE
The requirements of 49 CFR Part 26 including any amendments thereto apply to this contract. It is the
policy of the Owner, Pitkin County, to practice nondiscrimination based on race, color, sex, or national
origin in the award or performance of this contract. The Owner encourages participation by all firms
qualifying under this solicitation regardless of business size or ownership.
XII. TEXTING WHEN DRIVING
In accordance with Executive Order 13513, “Federal Leadership on Reducing Text Messaging While
Driving”, (10/1/2009) and DOT Order 3902.10, “Text Messaging While Driving”, (12/30/2009), the
Federal Aviation Administration encourages recipients of Federal grant funds to adopt and enforce
safety policies that decrease crashes by distracted drivers, including policies to ban text messaging
while driving when performing work related to a grant or subgrant.
In support of this initiative, the Owner encourages the Contractor to promote policies and initiatives
for its employees and other work personnel that decrease crashes by distracted drivers, including
policies that ban text messaging while driving motor vehicles while performing work activities
associated with the project. The Contractor must include the substance of this clause in all sub-tier
contracts exceeding $15,000 that involve driving a motor vehicle in performance of work activities
associated with the project.
XIII. PROHIBITION ON CERTAIN TELECOMMUNICATIONS AND VIDEO SURVEILLANCE SERVICES OR
EQUIPMENT
Contractor and Subcontractor agree to comply with mandatory standards and policies relating to use
and procurement of certain telecommunications and video surveillance services or equipment in
compliance with the National Defense Authorization Act P.L. 115-232, § 889(f)(1)).MODEL
SOLICITATION CLAUSE
XIV. FEDERAL FAIR LABOR STANDARDS ACT (FEDERAL MINIMUM WAGE)
All contracts and subcontracts that result from this solicitation incorporate by reference the provisions
of 29 CFR Part 201, et seq, the Federal Fair Labor Standards Act (FLSA), with the same force and effect
as if given in full text. The FLSA sets minimum wage, overtime pay, recordkeeping, and child labor
standards for full and part-time workers.
The Contractor has full responsibility to monitor compliance to the referenced statute or regulation.
The Contractor must address any claims or disputes that arise from this requirement directly with the
U.S. Department of Labor – Wage and Hour Division.
XV. CERTIFICATION REGARDING LOBBYING
The Bidder or Offeror certifies by signing and submitting this bid or proposal, to the best of his or her
knowledge and belief, that:
(1) No Federal appropriated funds have been paid or will be paid, by or on behalf of the Bidder or
Offeror, to any person for influencing or attempting to influence an officer or employee of an
agency, a Member of Congress, an officer or employee of Congress, or an employee of a
Member of Congress in connection with the awarding of any Federal contract, the making of
any Federal grant, the making of any Federal loan, the entering into of any cooperative
agreement, and the extension, continuation, renewal, amendment, or modification of any
Federal contract, grant, loan, or cooperative agreement.
(2) If any funds other than Federal appropriated funds have been paid or will be paid to any
person for influencing or attempting to influence an officer or employee of any agency, a
Member of Congress, an officer or employee of Congress, or an employee of a Member of
Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the
undersigned shall complete and submit Standard Form-LLL, “Disclosure Form to Report
Lobbying,” in accordance with its instructions.
(3) The undersigned shall require that the language of this certification be included in the award
documents for all sub-awards at all tiers (including subcontracts, subgrants, and contracts
under grants, loans, and cooperative agreements) and that all sub-recipients shall certify and
disclose accordingly.
This certification is a material representation of fact upon which reliance was placed when this
transaction was made or entered into. Submission of this certification is a prerequisite for making or
entering into this transaction imposed by 31 U.S.C. § 1352. Any person who fails to file the required
certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for
each such failure.
XVI. OCCUPATIONAL SAFETY AND HEALTH ACT OF 1970
All contracts and subcontracts that result from this solicitation incorporate by reference the
requirements of 29 CFR Part 1910 with the same force and effect as if given in full text. The employer
must provide a work environment that is free from recognized hazards that may cause death or
serious physical harm to the employee. The employer retains full responsibility to monitor its
compliance and their subcontractor’s compliance with the applicable requirements of the
Occupational Safety and Health Act of 1970 (29 CFR Part 1910). The employer must address any claims
or disputes that pertain to a referenced requirement directly with the U.S. Department of Labor –
Occupational Safety and Health Administration.
XVII. PROCUREMENT OF RECOVERED MATERIALS
Contractor and subcontractor agree to comply with Section 6002 of the Solid Waste Disposal Act, as
amended by the Resource Conservation and Recovery Act, and the regulatory provisions of 40 CFR Part
247. In the performance of this contract and to the extent practicable, the Contractor and
subcontractors are to use products containing the highest percentage of recovered materials for items
designated by the Environmental Protection Agency (EPA) under 40 CFR Part 247 whenever:
The contract requires procurement of $10,000 or more of a designated item during the fiscal
year; or
The contractor has procured $10,000 or more of a designated item using Federal funding during
the previous fiscal year.
The list of EPA-designated items is available at www.epa.gov/smm/comprehensive-procurement-
guidelines-construction-products.
Section 6002(c) establishes exceptions to the preference for recovery of EPA-designated products if
the contractor can demonstrate the item is:
a) Not reasonably available within a timeframe providing for compliance with the contract
performance schedule;
b) Fails to meet reasonable contract performance requirements; or
c) Is only available at an unreasonable price.
XVIII. CERTIFICATION OF OFFEROR/BIDDER REGARDING TAX DELINQUENCY AND FELONY
CONVICTIONS
The applicant must complete the following two certification statements. The applicant must indicate
its current status as it relates to tax delinquency and felony conviction by inserting a checkmark (ü) in
the space following the applicable response. The applicant agrees that, if awarded a contract resulting
from this solicitation, it will incorporate this provision for certification in all lower tier subcontracts.
Certifications
The applicant represents that it is ( ü ) is not ( ü ) a corporation that has any unpaid Federal tax
liability that has been assessed, for which all judicial and administrative remedies have been
exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an
agreement with the authority responsible for collecting the tax liability.
The applicant represents that it is ( ü ) is not ( ü ) a corporation that was convicted of a criminal
violation under any Federal law within the preceding 24 months.
Note
If an applicant responds in the affirmative to either of the above representations, the applicant is
ineligible to receive an award unless the Sponsor has received notification from the agency suspension
X
X
and debarment official (SDO) that the SDO has considered suspension or debarment and determined
that further action is not required to protect the Government’s interests. The applicant therefore
must provide information to the owner about its tax liability or conviction to the Owner, who will then
notify the FAA Airports District Office, which will then notify the agency’s SDO to facilitate completion
of the required considerations before award decisions are made.
Term Definitions
Felony conviction: Felony conviction means a conviction within the preceding twenty four (24)
months of a felony criminal violation under any Federal law and includes conviction of an
offense defined in a section of the U.S. Code that specifically classifies the offense as a felony
and conviction of an offense that is classified as a felony under 18 USC § 3559.
Tax Delinquency: A tax delinquency is any unpaid Federal tax liability that has been assessed,
for which all judicial and administrative remedies have been exhausted, or have lapsed, and that
is not being paid in a timely manner pursuant to an agreement with the authority responsible
for collecting the tax liability.
XIX. TERMINATION FOR CONVENIENCE (CONSTRUCTION & EQUIPMENT CONTRACTS)
The Owner may terminate this contract in whole or in part at any time by providing written notice to
the Contractor. Such action may be without cause and without prejudice to any other right or remedy
of Owner. Upon receipt of a written notice of termination, except as explicitly directed by the Owner,
the Contractor shall immediately proceed with the following obligations regardless of any delay in
determining or adjusting amounts due under this clause:
1. Contractor must immediately discontinue work as specified in the written notice.
2. Terminate all subcontracts to the extent they relate to the work terminated under the notice.
3. Discontinue orders for materials and services except as directed by the written notice.
4. Deliver to the Owner all fabricated and partially fabricated parts, completed and partially
completed work, supplies, equipment and materials acquired prior to termination of the work,
and as directed in the written notice.
5. Complete performance of the work not terminated by the notice.
6. Take action as directed by the Owner to protect and preserve property and work related to
this contract that Owner will take possession.
Owner agrees to pay Contractor for:
1. Completed and acceptable work executed in accordance with the contract documents prior to
the effective date of termination;
2. Documented expenses sustained prior to the effective date of termination in performing work
and furnishing labor, materials, or equipment as required by the contract documents in
connection with uncompleted work;
3. Reasonable and substantiated claims, costs, and damages incurred in settlement of terminated
contracts with Subcontractors and Suppliers; and
4. Reasonable and substantiated expenses to the Contractor directly attributable to Owner’s
termination action.
Owner will not pay Contractor for loss of anticipated profits or revenue or other economic loss arising
out of or resulting from the Owner’s termination action.
The rights and remedies this clause provides are in addition to any other rights and remedies provided
by law or under this contract.
XX. TERMINATION FOR CAUSE (CONSTRUCTION)
Section 80-09 of FAA Advisory Circular 150/5370-10 establishes standard language for conditions,
rights, and remedies associated with Owner termination of this contract for cause due to default of the
Contractor.
XXI. TERMINATION FOR CAUSE (EQUIPMENT)
The Owner may, by written notice of default to the Contractor, terminate all or part of this Contract
for cause if the Contractor:
1. Fails to begin the Work under the Contract within the time specified in the Notice- to-Proceed;
2. Fails to make adequate progress as to endanger performance of this Contract in accordance
with its terms;
3. Fails to make delivery of the equipment within the time specified in the Contract, including any
Owner approved extensions;
4. Fails to comply with material provisions of the Contract;
5. Submits certifications made under the Contract and as part of their proposal that include false
or fraudulent statements; or
6. Becomes insolvent or declares bankruptcy.
If one or more of the stated events occur, the Owner will give notice in writing to the Contractor and
Surety of its intent to terminate the contract for cause. At the Owner’s discretion, the notice may allow
the Contractor and Surety an opportunity to cure the breach or default.
If within [10] days of the receipt of notice, the Contractor or Surety fails to remedy the breach or
default to the satisfaction of the Owner, the Owner has authority to acquire equipment by other
procurement action. The Contractor will be liable to the Owner for any excess costs the Owner incurs
for acquiring such similar equipment.
Payment for completed equipment delivered to and accepted by the Owner shall be at the Contract
price. The Owner may withhold from amounts otherwise due the Contractor for such completed
equipment, such sum as the Owner determines to be necessary to protect the Owner against loss
because of Contractor default.
Owner will not terminate the Contractor’s right to proceed with the work under this clause if the delay
in completing the work arises from unforeseeable causes beyond the control and without the fault or
negligence of the Contractor. Examples of such acceptable causes include: acts of God, acts of the
Owner, acts of another Contractor in the performance of a contract with the Owner, and severe
weather events that substantially exceed normal conditions for the location.
If, after termination of the Contractor’s right to proceed, the Owner determines that the Contractor
was not in default, or that the delay was excusable, the rights and obligations of the parties will be the
same as if the Owner issued the termination for the convenience the Owner.
The rights and remedies of the Owner in this clause are in addition to any other rights and remedies
provided by law or under this contract.
XXII. TRADE RESTRICTION CERTIFICATION
By submission of an offer, the Offeror certifies that with respect to this solicitation and any resultant
contract, the Offeror –
1) is not owned or controlled by one or more citizens of a foreign country included in the list of
countries that discriminate against U.S. firms as published by the Office of the United States
Trade Representative (USTR);
2) has not knowingly entered into any contract or subcontract for this project with a person that
is a citizen or national of a foreign country included on the list of countries that discriminate
against U.S. firms as published by the USTR; and
3) has not entered into any subcontract for any product to be used on the Federal project that is
produced in a foreign country included on the list of countries that discriminate against U.S.
firms published by the USTR.
This certification concerns a matter within the jurisdiction of an agency of the United States of America
and the making of a false, fictitious, or fraudulent certification may render the maker subject to
prosecution under Title 18 USC § 1001.
The Offeror/Contractor must provide immediate written notice to the Owner if the Offeror/Contractor
learns that its certification or that of a subcontractor was erroneous when submitted or has become
erroneous by reason of changed circumstances. The Contractor must require subcontractors provide
immediate written notice to the Contractor if at any time it learns that its certification was erroneous
by reason of changed circumstances.
Unless the restrictions of this clause are waived by the Secretary of Transportation in accordance with
49 CFR § 30.17, no contract shall be awarded to an Offeror or subcontractor:
1) who is owned or controlled by one or more citizens or nationals of a foreign country included on
the list of countries that discriminate against U.S. firms published by the USTR; or
2) whose subcontractors are owned or controlled by one or more citizens or nationals of a foreign
country on such USTR list; or
3) who incorporates in the public works project any product of a foreign country on such USTR list.
Nothing contained in the foregoing shall be construed to require establishment of a system of records
in order to render, in good faith, the certification required by this provision. The knowledge and
information of a contractor is not required to exceed that which is normally possessed by a prudent
person in the ordinary course of business dealings.
The Offeror agrees that, if awarded a contract resulting from this solicitation, it will incorporate this
provision for certification without modification in all lower tier subcontracts. The Contractor may rely
on the certification of a prospective subcontractor that it is not a firm from a foreign country included
on the list of countries that discriminate against U.S. firms as published by USTR, unless the Offeror has
knowledge that the certification is erroneous.
This certification is a material representation of fact upon which reliance was placed when making an
award. If it is later determined that the Contractor or subcontractor knowingly rendered an erroneous
certification, the Federal Aviation Administration (FAA) may direct through the Owner cancellation of
the contract or subcontract for default at no cost to the Owner or the FAA.
XXIII. VETERAN’S PREFERENCE
In the employment of labor (excluding executive, administrative, and supervisory positions), the
Contractor and all sub-tier contractors must give preference to covered veterans as defined within 49
U.S.C. § 47112. Covered veterans include Vietnam-era veterans, Persian Gulf veterans, Afghanistan-
Iraq war veterans, disabled veterans, and small business concerns (as defined by 15 U.S.C. § 632)
owned and controlled by disabled veterans. This preference only applies when there are covered
veterans readily available and qualified to perform the work to which the employment relates.
XXIV. CERTIFICATION REGARDING DOMESTIC PREFERENCES FOR PROCUREMENTS
The Bidder or Offeror certifies by signing and submitting this bid or proposal that, to the greatest
extent practicable, the Bidder or Offeror has provided a preference for the purchase, acquisition, or
use of goods, products, or materials produced in the United States (including, but not limited to, iron,
aluminum, steel, cement, and other manufactured products) in compliance with 2 CFR § 200.322.
XXV. PROHIBITION OF COVERED UNMANNED AIRCRAFT SYSTEMS (UAS)
The Bidder or Offeror certifies that they are aware of and comply with relevant Federal statutes and
regulations, including those from the Federal Aviation Administration (FAA), for operating unmanned
aircraft systems (UAS) in accordance, and in compliance with all related requirements in the FAA
Reauthorization Act of 2024 (Public Law 118-63), section 936 (49 U.S.C. § 44801 note).
Contractor warrants that all UAS operations will be conducted in full compliance with all applicable
Federal Aviation Administration (FAA) regulations, including but not limited to 14 CFR Part 107, and
any other applicable local, state, or Federal laws and regulations.
Sponsors and subgrant recipients cannot use AIP grant funds to enter into, extend, or renew a contract
related to covered unmanned aircraft systems (UAS). This includes both procurement and operational
contracts, as well as contracts with entities that operate such systems.
Certificate Of Completion
Envelope Id: 95627457-B672-8E1A-8255-0190E2D9A6A4 Status: Completed
Subject: Lumen | Pitkin County Contract 101.26 (revision 1) for Review & Signature
Source Envelope:
Document Pages: 35 Signatures: 6 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: 2601:281:17f:16
Record Tracking
Status: Original
7/21/2026 4:10:34 PM
Holder: Pitkin County Procurement
Procurement@PitkinCounty.com
Location: DocuSign
Signer Events Signature Timestamp
Anne Marie McPhee
anne.mcphee@pitkincounty.com
Deputy County Attorney
Security Level: Email, Account Authentication
(None)Signature Adoption: Pre-selected Style
Using IP Address: 65.38.144.66
Sent: 7/21/2026 4:50:04 PM
Viewed: 7/21/2026 4:57:51 PM
Signed: 7/21/2026 5:02:18 PM
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Diane Jackson
diane.jackson@aspenairport.com
Airport Director
Security Level: Email, Account Authentication
(None)Signature Adoption: Pre-selected Style
Using IP Address: 65.38.144.66
Sent: 7/21/2026 5:02:22 PM
Viewed: 7/22/2026 5:07:27 PM
Signed: 7/22/2026 5:08:02 PM
Electronic Record and Signature Disclosure:
Accepted: 7/22/2026 5:07:27 PM
ID: 33f94334-06b0-431e-b910-7e64c71cb050
Company Name: Pitkin County, Colorado
Jason Sharpe
jason.sharpe@lumen.com
Senior Network Implementation Engineer
Lumen
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 155.70.104.117
Sent: 7/22/2026 5:08:06 PM
Viewed: 7/23/2026 9:32:12 AM
Signed: 7/23/2026 9:37:09 AM
Electronic Record and Signature Disclosure:
Accepted: 7/23/2026 9:32:12 AM
ID: ad48a3de-5f46-4e48-b31a-f26754f2040a
Company Name: Pitkin County, Colorado
Ryan Mahoney
ryan.mahoney@pitkincounty.com
Deputy County Manager
Signing Group: County Manager Group
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 65.38.144.66
Sent: 7/23/2026 9:37:13 AM
Viewed: 7/23/2026 10:44:04 AM
Signed: 7/23/2026 4:34:45 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
Ruslana Ivanova, Procurement Specialist
Pitkin County
Security Level: Email, Account Authentication
(None)
Sent: 7/23/2026 4:34:49 PM
Resent: 7/23/2026 4:34:59 PM
Viewed: 7/23/2026 4:54:17 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: 7/23/2026 4:34:49 PM
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Gabriel Galicia
Gabriel.Galicia@PitkincOunty.com
Grant & Capital Asset Accountant
Pitkin County
Security Level: Email, Account Authentication
(None)
Sent: 7/23/2026 4:34:50 PM
Electronic Record and Signature Disclosure:
Not Offered via Docusign
G.R. Fielding
g.r.fielding@jacobsendaniels.com
Security Level: Email, Account Authentication
(None)
Sent: 7/23/2026 4:34:51 PM
Viewed: 7/23/2026 4:37:27 PM
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 7/21/2026 4:50:04 PM
Certified Delivered Security Checked 7/23/2026 10:44:04 AM
Signing Complete Security Checked 7/23/2026 4:34:45 PM
Completed Security Checked 7/23/2026 4:34:51 PM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
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Electronic Record and Signature Disclosure created on: 3/20/2020 3:28:13 PM
Parties agreed to: Diane Jackson, Jason Sharpe
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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.