C153301 Contract

• Contract/PO #: C153301
• Contractor Name: Cache La Poudre Reservoir Company
• Contract Type: Loan
• Water District: 3
• County: Larimer
• Bill Number: SB 77-35
• Loan Projects - Doc Type: Contract Documents

~

CEHTIFICATION

.

TO: Rudolph Livingston
Executive Director
Depar,troent of Personnel
118 State Centennial Building
1313 St1erman Street
Denver, Colorado 80203

RE: Personal Service Contract Classification

The undersigned hereby certifies the attached contract, Contract Routing
No. , from the Department of Natural ResourcesDepartrnent),
has been examined, and U,e following have been determined concerning the correct
classification of the contractor undertaking U,e services and work which are the
'" suLject of the contract. The contractor is a firm or individual __

(a) -- who is responsible for the results of the work to be undertaken,
but is not subject to the State's control as to the means and methods
of accomplishing these result~.

X YES _____NO

(b) -- who selects his clients ana is free to work for one or more during
any g~ven interval.

.

x YES _____NO
(c) -- who determines the time anO place the work will be performed.

~

YES

NO

(d) -- who provides the tools, materials and office space needed to
perform the work.

-x-YES NO

(e) -- whO does not participate d~rectly or indirectly in benefit
programs of the State. (For "xample, is not covered by the State
for workmen's Compensation inGuring for injury to himself; for
Public Liability insuring for injury to others; or for unemployment
compensa tion)

x

YES

NO'

(f) -- who may agree to perform specific services for a fixed price
and generally does not receive regular amounts at stated intervals.

x

YES'

NO

Affirmative responses to the listed classification indicia identify the
services to be contracted as those ot an independent contractor, negative
responses as those of a (temporary) employee. Any negative response where the
certified classification is that of an independent contractor will require, in
addi tion, a qua lit lea tion by written explana tion accompany ing this certif ica tion.
If the explanation is not attached, the classification shall be preswned to be
that of an e~ployee.

Accordingly, the attached contract is determined to be and is so certified
as an independent contractor/temporary employee (strike one). contract.

SIGNED this Is t day of Junp.

, 1978.

STATE OF COLORADO

DEPARTMENT OF Natural Reeourcell

By~;tJ~
E . SHERMAN
EXECUTIVE DIRECTOR

--"-"