Facilitation certification for personal servic

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THE FOLLOWING TO BE COMPLETED BY HR PERSONNE L ONLY 1. I attest that the acquisition of services from the independent contractor will not result in the separation or displacement of state personnel system staff. Employees directly affected by the contract will be given proper notices as defined in R ule 10 - 5. 2. Review/Approval Criteria: The following are statutory citations by which the impacts to state personnel system staff are evaluated. Please identify those statutory criteria that would make this request an approvable agreement. The contract meets the relevant cost savings test. A “Cost Analysis” form must be completed and attached to this form. C.R.S. 24 - 50 - 503 The contracts is for a new state program (created after 4/7/93), which statutorily authorizes the performance of the program by in dependent contracts. C.R.S. 24 - 50 - 504(2)(b) The contracted services are not available within the state personnel system, or cannot be performed satisfactorily by state employees, or are of a highly specialized or technical nature. C.R.S. 24 - 50 - 504(2)( c) The services are incidental to a contract for the purchase or lease of real or personal property. C.R.S. 24 - 50 - 504(2)(d) The contract is needed to protect against a conflict of interest, or to ensure independent and unbiased findings in cases where there is a clear need for a different, outside perspective. C.R.S. 24 - 50 - 504(2)(e) The contractor will provide equipment, materials, facilities, or support services that could not feasibly by provided by the state in the location where the services a re to be performed. C.R.S. 24 - 50 - 504(2)(f) The contractor will conduct training courses for which appropriately qualified state personnel system instructors are not available. C.R.S. 24 - 50 - 504(2)(g) The services are of an urgent, temporary, or occasi onal nature. C.R.S. 24 - 50 - 504(2)(h) The contract is for purchased services. (The acquisition of services which directly benefit specific groups or individuals in the public at large.) C.R.S. 24 - 50 - 504(3) This is an intergovernmental agreement. C.R. S. 24 - 50 - 508 The services provided are for a term of six months or less and are not expected to recur on a regular basis. C.R.S. 24 - 50 - 513 PERSONAL SERVICES CERTIFICATION HR Representative ONLY Independent Contractor Certification: The signature below indicates that the contract or commitment voucher is indeed an independent contract that does not create an employee - employer relationship and that these documents contain the required independent contractor language as part of the Director’s Rules 10 - 4(E )(4). Department/Institution Certification: I hereby certify that the attached agreement for personal services meets at least one criterion stated above and that all responses on this certification are true and accurate, to the best of my knowledge. Date : by: Human Resource Representative Title/Work Phone Number Revised document DPA 11/30/05 3