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Home My WebLink Aboutbocc.con.113.2007 CLERK'S CHECK LIST FOR CONTRACTS SUBMITTED TO CLERK AND RECORDER FOR SCANNING/ARCHIVING Originating Department/Division: Contact Person: Project Name: D BOCC AGENDA ITEM (BOeC signature required) CONTRACT #: 1/3-?otJ'7 Phone #: DSTAFF AUTHORIZED SIGNATURE (per Revised Procurement Code 7/2005) ~ck procurement type: WNone DInformal DFormal DSole Source DEmergency DState Bid D Check Contract Tvpe: Dollar Amount:9' 5l./00 ~rviceslMaintenance DLicense/Use DLease DConstruction DGoods, Equipment, Supplies DOther (e.g. revenue) ContractorlBusiness Contract Execution {g -('1-01 Automatic Renewal Iv' Budget Line ItemlLedger Number ()O/33 <)03:J.Y-'fjClCY.J.'it DEmployment (for county employees) DIntergovermnental Agreement (Requires BOCC Action) DNon-Profit DQuasi-Public DGrant Agreements (Requires BOCC Action) DChange Order/Contract Amendment Complete Name: Contract End Date: Term of Contract: &-('{-o'it I '1...L<~ All Contracts should be proofed for the following: ~o Pages Missing ~If a Page is Left Intentionally Blank -Note on Page 0Page numbered consecutively 0AII Signatures Affixed [i2JAII Dates Filled In ~II Other Blanks Filled In All Exhibits Attached II Legal Descriptions Attached (if appropriate) , Notice of Award/Proceed Attached (if appropriate) ~Special Instructions for Finance Department: [Z]Sent to Clerk and Recorder for Scanning/Archiving l::]Authorized Staff Person's Name: BY CHECKING ABOVE AND ENTERING NAME, THE AUTHORIZED STAFF PERSON INDICATES 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. Amended 10_16_06 CONTRACT II Ili-1.a11 INDEPENDENT CONTRACTOR AGREEMENT I ...,...-: This Agreement is made and entered into this 11/ ~ day of ~ t.1~, .ia? r. by and between Pitkin County Board of County Commissioners, hereinafter the "County" and David Borchers, hereinafter "Borchers" 100 Elk Run Drive, Suite 101, Basalt, Colorado, 81621. TERM OF AGREEMENT The work and duties to be performed by the parties shall be from ~ 7', M () /until ::]UN\L /'1. 7doll"(one year). At the expiration of the initial terrff of this agreement, the agreement may be extended for an additional period BY the express written consent of the parties. SERVICES TO BE PROVIDED BY BORCHERS TO COUNTY Clinic Physician The clinic physician will be responsible for: 1. Supervision of inmate medical care, and the Jail nurse who will conduct weekly sick call visitation to the jail, and preliminary health appraisals of those persons who remain in the jail beyond 14 days; and coordination with the Jail nurse and others regarding the delivery of health care, especially the administration of medication. 2. The care of all prisoners with chronic, convalescent, or other special health problems that may arise in the jail. This will include consultation on decisions to transfer persons to facilities better able to care for specific problems and medically supervised detoxification for chemically dependent inmates who cannot be transferred to a more appropriate facility. 3. Approval of written policies and procedures relating to health care delivery and the maintenance of medical records. 4. A quarterly review of the jail health care delivery system to include: 1) The effectiveness of the medical care system to include: a. Results of quarterly discussion of practices and problems with the jail b. Observation and comment on any environmental factors which may affect medical care delivery in the jail; c. Changes in the system since the previous report; 2) Recommendations for changes in jail health care system as deemed necessary or appropriate. 5. Approve health education programs to staff. PAYMENT FOR SERVICES FROM COUNTY TO BORCHERS Borchers shall be paid at the regular rates per standard office superbill, the total of which shall not exceed $10,000 per year for the services provided. Borchers represents that he is familiar with the requirements of the jail for the services he is to provide herein and that he will be able to provide all the necessary services required by the jail as stated herein. CANCELLATION OF AGREEMENT The Parties reserve the right to cancel this agreement for any reason, by giving written notice, by first class mail at the following address: Dr. David Borchers 100 Elk Run Drive Suite 101 Basalt, CO 81621 Don Bird, Jail Administrator 506 E. Main Street Aspen, CO 81611 PROFESSIONAL ACCREDITATION Borchers agrees to remain licensed and in good standing with all State licensing and professional boards in the State of Colorado during the duration of the agreement and any renewals thereof. Borchers further agrees to provide the County proof of such licensing and accreditation upon request at any time during the term of this agreement or renewals thereof. INSURANCE Borchers agrees to obtain at his expense and to maintain at his expense professional liability insurance in the minimum amount of $1,000,000.00 for each incident and $3,000,000.00 in the aggregate to cover his responsibilities and services to be provided to the County. The form and level of insurance obtained and maintained by Borchers shall be in a form satisfactory to the County Attorney and the County Risk Manager. Borchers further agrees to provide the County with proof of insurance coverage upon request at any time during the term of this agreement or renewals thereof and shall list Pitkin County as an additional insured. INDEMNIFICATION Borchers agrees to hold the County harmless, indemnify and defend the County for all damages to his and third parties and to all real and personal property occasioned by or during the performance of this agreement. INDEPENDENT CONTRACTOR STATUS It is understood and agreed between the parties that at no time shall Borchers be considered an agent, employee or official of the County during the performance of tasks and services described herein. The relationship created hereby is for all purposes strictly that of an independent contractor. You acknowledge and agree that you shall not be entitled to workers' compensation benefits in connection with this project and that you shall be responsible for the payment of all state and federal income taxes. ASSIGNABILITY This contract is assignable only with approval of the Jail Administrator. In Witness Whereof, the parties hereto have caused this agreement to be executed as of the day and year first above written. D, D,,;d Bo ,;" ~ c.fjo or-- Don Bird, Jail. Administrator County Attorney 71 ;t Kris Jewkes, Risk Manager 1!~9fJ~ CERTIFlCA TE OF PROFESSIONAL LIABILITY INSURANCE CERTIFICATE HOLDER INSURED Borchers, David 1. M.D. 100 Elk Run Drive Suite 10 I Basalt, CO 81621 David 1. Borchers, M.D. 100 Elk Run Drive Suite 10 I Basalt CO 81621 This certificate is issued as a matter of information only and confers no rights upon the holder. By its issuance, the Company does not alter, change, modify or extend the provisions of said policy and does not waive any of its rights thereunder. POLICY NUMBER: PCC0003060 POLICY PERIOD: 07/13/2006 to: 07/13/2007 RETROACTIVE DATE: 07/13/1998 LIMITS OF LIABILITY: Per Medical Incident/Peer Review Incident: $ Annual Aggregate: $ 2,000,000 4,000,000 SPECIALTY: Internal Medicine-N.O.C. Dated at: Denver, Colorado Date: July 7, 2006 ~('h ~ ,~ Countersigned by Authorized Representative C1C-0004AG 09/0112005 CERTIFICATE HOLDER Post Office Box 17540 Denver, Colorado 80217-0540 (720) 858-{j()()() 1-800-421-1834 FAX (720) 858~