HomeMy WebLinkAboutbocc.con.005.2005 CHECK LIST
FOR CONTRACTS SUBMITTED TO CLERK AND RECORDER FOR
SCANNING/ARCHIVING
Originating Department/Division: M~t / ~_.'_nt~ th qA'
Contact Person: ~en~ t~a,n,n~b,~ t~
Phone #: 4t-~tl ~&~/q~,
BOCC AGENDA ITEM (BOCC signature required)
STAFF AUTHORIZED SIGNATURE (as per Procurement Code)
Check Contract Type: Dollar Amount:
)~ Services
Maintenance
License/Use
Lease OOblTFIAI~T # tgd,5'~2~
Construction
Purchase
Employment
Intergovernmental Agreement (Requires BOCC Action)
Non Profit
___Quasi-Public
__Grant Agreements (Requires BOCC Action)
Other
STAFF AUTHORIZED
SIGNATURE
Signatures Required:
Under 25K - Department Head
25-50K - Department Head (if appropriate), Section Leader
Over 50 K - Department Head (if appropriate), Section Leader, County Manager
Contractor/Business (Complete Name):
Contract Start Date:
Automatic Renewal (Y~
ContYact End ]bat~: ~ · ~ t: ~'~ '~
All Contracts should be proofed for the following:
· No Pages Missing
· If a Page is Left Intentionally Blank - Note on Page
· Page numbered consecutively
· Ail Signatures Affixed
· All Dates Filled In
· All Other Blanks Filled In
· All Exhibits Attached
· All Legal Descriptions Attached (if appropriate)
· Notice of Award/Proceed Attached (if appropriate)
Sent to Clerk and Recorder for Scanning/Archiving
Date: /
Authfitrized Staff Person
Signature of authorized staff person indicate that document has been proofed and ready
for scanning.
Note: Clerk's Office will keep original documents in compliance with Colorado
State Archives retainage schedule.
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STAFF AUTHORIZED
SIGNATURE
CONTRACT®
AGREEMENT AMENDMENT ......
The Agreement for Provision of Professional Services (the "Agreement") dated January 1, 2004
through December 31, 2004 between Pitkin County (the "County") and Gallagher Benefit
Service, Inc. (the "Contractor"), is hereby amended as follows:
· The agreement date is January 1, 2004 through December 31, 2004. This should be
changed to January 1, 2005 to December 31, 2005.
"For the performance of services hereunder, the Contractor shall be compensated an
amount of $36,000. This amount will be offset by commissions included in the employee
benefit programs. Contractor shall at the year-end provide a summary of commissions
received, and shall reserve the right to submit an invoice for any difference in
compensation between the agreed upon amount and the compensation and commissions
actually received. For any work outside the scope of services described hereunder,
Contractor shall advise the County of any additional required compensation, and obtain
written authorization to proceed prior to commencement of such services. Payment of
invoices associated with such s~rvices is contingent upon comPletion of such services to
the Satisfaction of the County. Invoices shall itemize specific work done to complete the
task, and include receipts for all reimbursable items. Within thirty (30) days of receipt of
an invoice and approval thereof as required hereunder, payment shall be made by the
County." The amount should be replaced with $38,500.
In all other respects the Agreement is in full force and effect and remains unchanged by
this Amendment.
EXECUTED this ~9~ day of d~,~t~ .Io~'-~.'
PITKIN COUNTY:
By: Am~ Barwick -
Human Resources/Risk Management Director
~ Don Heilman
Area Vice President
APPROVED AS TO FORM, this
Co__ce
Procur~tnent Officer
day of
~s Je~'kes, Risk~a~geme'n~' !
Section ~ead (>$25,60~