HomeMy WebLinkAbout20252906.tiff Resolution
Approve Memorandum of Agreement to Purchase Property Interest for Acquisition
of Public Road Right-of-Way for County Road 29 Improvements Project Between
State Highway 392 and County Road 74, and Authorize Chair to Sign —
Cheryl Cabaruvias
Whereas, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
Whereas, the Board has been presented with a Memorandum of Agreement to Purchase
Property Interest for the Acquisition of Public Road Right-of-Way for the County Road 29
Improvements Project, between State Highway 392 and County Road 74, between the
County of Weld, State of Colorado, by and through the Board of County Commissioners
of Weld County, on behalf of the Department of Public Works, and Cheryl Cabaruvias,
commencing upon full execution of signatures, with further terms and conditions being as
stated in said agreement, and
Whereas, after review, the Board deems it advisable to approve said agreement, a copy
of which is attached hereto and incorporated herein by reference.
Now, therefore, be it resolved by the Board of County Commissioners of Weld County,
Colorado, that the Memorandum of Agreement to Purchase Property Interest for the
Acquisition of Public Road Right-of-Way for the County Road 29 Improvements Project,
between State Highway 392 and County Road 74, between the County of Weld, State of
Colorado, by and through the Board of County Commissioners of Weld County, on behalf
of the Department of Public Works, and Cheryl Cabaruvias, be, and hereby is, approved.
Be it further resolved by the Board that the Chair be, and hereby is, authorized to sign
said agreement.
5068801 Pages: 1 of 8 CC:PW(CH/KM/M%/dr1/SS) 2025-2906
11/2Carly 5Koppes,/2025 0Clerk
and Recorder,,OWed County , CO 12 7oy/25 EG0083
•11 kIcitiMI A1 1141:ICA PC! 'RNJ �,'Y4rh 1111
Memorandum of Agreement to Purchase Property Interest for Acquisition of Public Road
Right-of-Way for County Road 29 Improvements Project Between State Highway 392 and
County Road 74 — Cheryl Cabaruvias
Page 2
The Board of County Commissioners of Weld County, Colorado, approved the above
and foregoing Resolution, on motion duly made and seconded, by the following vote on
the 27th day of October, A.D., 2025:
Perry L. Buck, Chair: Aye rr+ �-•.y
Scott K. James, Pro-Tern: Aye 41,'!� \4a i 40 ��
Jason S. Maxey: Excused I %
Lynette Peppler: Excused
Kevin D. Ross: Aye
Approved as to Form: r,, r,,I
Bruce Barker, County Attorney
Attest:
Esther E. Gesick, Clerk to the Board
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Carly Koppes, Clerk and Recorder, Weld County , CO
1111 1 rj!1. :'lliNl10;M Wit Mtliffl4FL FAL 11111
Cun} ci ID* IUOIq
i1: ! D `` q - " ' MEMORANDUM
�' �� TO: Esther Gesick,Clerk to the Board DATE: 10/16/25
" 41. , Ill r
r y `, FROM: Michael Bedell,P.E.&Val Mino Public Works Department
SUBJECT:ROW less than$5,000
5 Jr
Please place the following Right-of-Way(ROW)item on the next available BOCC Agenda,without a BOCC pass-around
memo. This ROW acquisition is associated with the WCR 29, from Hwy 392 to WCR 74 Project and the proposed
amount of payment to the landowner(Cheryl A.Cabaruvias)is$1300.00.
pc:
M:\'Administration\Forms\MEMO-Form.doc
2025-2906
10/2l ET100%3
MEMORANDUM OF Project Code:N/A Parcel No:080509000043
AGREEMENT TO PURCHASE Project No:SFT-13
PROPERTY INTEREST Location:WCR 29-HWY 392 TO WCR 74
County:Weld nn ,,,,�� State Highway No:N/A
This Memorandum of Agreement("Agreement")made on OC' IICr 9 1(/�CC is between Weld County
(GRANTEE)for the purchase of the parcel(s)listed above from the
Owner(s) Cheryl A.Cabaruvias (GRANTOR).
Just compensation was determined by an appropriate valuation procedure prepared in accordance with Colorado
state laws and regulations.The amount of money and/or compensation listed below is full consideration for the
following land,easements,improvements,and damages of any kind.
Land(RW) Sq.ft®/acres❑ $ 1,000.00
Permanent and Slope Easements Sq.ft❑/acres❑ $
Temporary Easements(TE) Sq.ft❑/acres❑ $
30%Incentive: $300.00
Damages: $
Gross Total $1,300.00
Less Credit $
Net Total $1,300.00
Other conditions:
See attached Addendum.
The GRANTOR:
I)Represents that he or she is the legal owner of the property and has the right to convey the property in the
manner detailed in this Agreement;
2)Acknowledges that just compensation was determined by an appropriate valuation procedure prepared in
accordance with applicable laws and regulations,and hereby knowingly waives any right to contest such
valuation;
3)Agrees the amount of money and/or compensation listed above is full consideration for the following land,
easements,improvements,and damages of any kind whatsoever;
4)Will,at the closing,pay all taxes(including prorated taxes for the current year)and special assessments for the
current year;
5)Has entered into this agreement because the GRANTEE has the power of eminent domain and requires the
property for public purposes;
6)Shall be responsible for securing releases from all liens,judgments and financial encumbrances to deliver clear,
unencumbered title to GRANTEE.Any encumbrance required to be paid by GRANTOR shall be paid at or
before closing from the proceeds of the transaction hereby contemplated or from any lawful other source;
7)Will execute and deliver to GRANTEE those documents necessary for this transaction as indicated below;
8)Excepts from the subject property described herein in the attached Exhibits,the mineral estate and including all
coal,oil,gas and other hydrocarbons,and all clay and other valuable mineral in and under said subject property.
The GRANTOR hereby covenants and agrees that the GRANTEE shall forever have the right to take and use,
without payment of further compensation to the GRANTOR,any and all sand,gravel,earth,rock,and other road
building materials found in or upon said subject property and belonging to the GRANTOR;and
9)The GRANTOR further covenants and agrees that no exploration for,or development of any of the products,as
described above,and owned by the GRANTOR heretofore or hereafter the date set forth above and hereby
excepted will ever be conducted on or from the surface of the premises described in the attached Exhibits,and
that in the event any of such operations may hereafter be carried on beneath the surface of said premises,the
GRANTOR shall perform no act which may impair the subsurface or lateral support of said premises. These
covenants and agreements hereunder,shall inure to and be binding upon the GRANTOR and its heirs,personal
and legal representatives,successors and assigns forever.
10)Acknowledges and agrees that by signing this Agreement,it may be waiving rights,including,but not limited
to,the right to contest GRANTEE's taking of possession or title to the property by eminent domain.
1 t)GRANTOR warrants and represents to GRANTEE that the Property has never been used as a landfill or waste
dump;there has been no installation in or production,use,release,disposal,or storage on the Property of any
hazardous substances or other toxic substance,and there is no pending or threatened proceeding,inquiry,action,
litigation or order by any court,governmental authority or agency with respect to the Property under any
Environmental Laws or otherwise.
12)GRANTOR warrants that if such property or any part thereof'is acquired by the GRANTOR after the date of
transfer,that such after acquired title is conveyed to the GRANTEE.
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Carly Koppes, Clerk and Recorder, Weld County , CO
III 1IMPT Nti 1 1U '4ng i luil«1 RAIWA KJ lid III II I 2 ozs 2ci 0(p
NOTE: At GRANTOR'S sole discretion,the GRANTOR may convey the underlying mineral estate owned by
GRANTOR to the GRANTEE. GRANTEE makes no representations about the nature,title or value of the mineral
estate. In transactions where GRANTOR conveys the underlying mineral estate to GRANTEE,Paragraphs 8 and 9,
as set forth above,will be deleted from this Memorandum of Agreement and the conveyance document.
❑ GRANTOR conveys the underlying mineral estate to GRANTEE. Paragraphs 8 and 9 are hereby deleted from
the Memorandum of Agreement and the conveyance document.
The GRANTEE:
1)Will be entitled to specific performance of this agreement upon tender of the agreed consideration;
2)Will be held harmless from any claims against the property or to any interest in the property,except for any
benefits due under relocation law;
3)Will make payment after receiving acceptable conveyance instruments from the GRANTOR;
4)Will take possession and use of the parcel(s)when it deposits the consideration,as set forth above,into an
escrow account for the benefit of the GRANTOR,or when GRANTEE disburses funds to GRANTOR.Transfer
of title to the parcel(s)shall occur upon performance of any and all terms under this agreement,and release of
the payment from escrow to the GRANTOR,unless other arrangements are made that follow Title III of the
Uniform Relocation Assistance and Real Property Acquisition Act of 1970,as amended;and
5)Will prepare the following documents:
® Deed of Dedication ❑ Utility Easement
❑ Access Deed ❑ Permanent Easement
❑ Full Release(s) Book/Page: ❑ Slope Easement
❑ Partial Release(s) Book/Page: ❑ Temporary Easement
Order Warrant$1.300.00 Payable to:Cheryl A.Cabaruvias
Order Warrant$ Payable to:
GRANTOR:Chery A.Cabaruvi
By:
TTE : D C UNTY ERK T THE BOARD OF COUNTY COMMISSIONERS WELD
BOARD e i
akcepl4. COUNTY,COLORADO
BY: BY: -Z Cazi----A-
Deputy lerk to the Board Perry L.Buck,C OCTlr 1 2 ! 202
APPROVED AS TO FORM: r/ 111.1
County Attorney:
186t ) II
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•.r® _ 4��
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Carly Koppes, Clerk and Recorder, Weld County , CO
III PEA,116 101014 h11:11Arc II
Page 2 of 3 WELD/CDOT Form#784-04/2024 Q
ZoZ5-2 l°Q
ADDENDUM:
1)This Agreement and the conveyance of the Property made pursuant to the terms herein,shall be binding upon,all
and inure to the benefit of and be enforceable by the parties and their heirs,executors,administrators,successors,
and assigns.
2)This Agreement shall not be valid until it has been approved by the Board of County Commissioners of Weld
County,Colorado or its designee.
3)No term or condition of this contract shall be construed or interpreted as a waiver,express or implied,of any of
the immunities,rights,benefits,protections,or other provisions,of the Colorado Governmental Immunity Act§24-
10-101 et seq.,as applicable now or hereafter amended.
4)This Agreement including the Exhibits attached hereto and incorporated herein,contains the entire agreement
between the parties with respect to the subject matter contained in this Agreement. This instrument supersedes all
prior negotiations,representations,and understandings or agreements with respect to the subject matter contained in
this Agreement. No oral representation,promise,or consideration different from the terms herein contained shall be
binding on either party,or its agents or employees. This Agreement maybe changed or supplemented only by a
written instrument signed by both parties.
5)Colorado law,and rules and regulations established pursuant thereto,shall be applied in the interpretation,
execution,and enforcement of this Agreement.Any provision included or incorporated herein by reference which
conflicts with said laws,rules and/or regulations shall be null and void.In the event of a legal dispute between the
parties,the parties agree that the Weld County District Court shall have exclusive jurisdiction to resolve said
dispute.
6)If any term or condition of this Agreement shall be held to be invalid,illegal,or unenforceable by a court of
competent jurisdiction,this Agreement shall be construed and enforced without such provision,to the extent that
this Agreement is then capable of execution within the original intent of the parties.
7)In the event of litigation between the parties in connection with this Agreement,the parties agree that each party
shall be responsible for the payment of their respective attorney fees and/or legal costs incurred by or on its own
behalf.
8)Any right or obligation in this Agreement that,by its terms,exists or is intended to be performed after termination
or Closing will survive Closing of this Agreement and will not be merged into the deed of the Property delivered by
GRANTOR or GRANTEE at Closing.
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Carly Koppes, Clerk and Recorder, Weld County , CO
1111 I ELIA rf1n 14'im hL LI/ 11111
Page 3 of 3 WELD/CDOT Form#784—04/2024
EXHIBIT-A
PROPERTY DESCRIPTION
A PARCEL OF LAND, LOCATED IN THE SOUTHWEST ONE—QUARTER OF SECTION 9, TOWNSHIP 6 NORTH, RANGE 66
WEST OF THE SIXTH PRINCIPAL MERIDIAN, COUNTY OF WELD, STATE OF COLORADO, SAID PARCEL BEING A
PORTION OF LOT—A OF RECORDED EXEMPTION NO. 0805-9-3—RE 780, FILED IN THE WELD COUNTY CLERK AND
RECORDERS OFFICE UNDER RECEPTION NO. 2041013, DATED JANUARY 29, 1986, AND BEING MORE PARTICULARLY
DESCRIBED AS FOLLOWS:
COMMENCING AT THE SOUTHWEST CORNER OF SECTION 9, TOWNSHIP 6 NORTH, RANGE 66 WEST, DESCRIBED AS
SHOWN AND IS BASED ON A GRID BEARING OF THE WEST LINE OF SAID SOUTHWEST ONE—QUARTER AS BEARING
NORTH 00'56'36" WEST, A DISTANCE OF 2664.81 FEET, TO THE WEST ONE—QUARTER CORNER OF SECTION 9,
TOWNSHIP 6 NORTH, RANGE 66 WEST, ALSO DESCRIBED AS SHOWN;
THENCE NORTH 43'51'01" EAST, A DISTANCE OF 42.58 FEET, TO A POINT ON THE NORTHERLY RIGHT—OF—WAY
LINE OF COUNTY ROAD 70, DESCRIBED IN ROAD VIEWERS REPORT FILED IN THE WELD COUNTY CLERK AND
RECORDERS OFFICE AT RECEPTION NUMBER 34224 DATED OCTOBER 11, 1889, AND ALSO BEING A POINT ON THE
EASTERLY RIGHT—OF—WAY LINE OF COUNTY ROAD 29, DESCRIBED IN ROAD VIEWERS REPORT FILED IN THE WELD
COUNTY CLERK AND RECORDERS OFFICE AT RECEPTION NUMBER 15165, DATED JANUARY 08, 1885, AND BEING
' THE TRUE POINT OF BEGINNING.
THENCE ALONG SAID EASTERLY RIGHT—OF—WAY LINE, NORTH 00'56'36" WEST, A DISTANCE OF 20.00 FEET;
THENCE DEPARTING SAID EASTERLY RIGHT—OF—WAY LINE, SOUTH 46'08'59" EAST, A DISTANCE OF 28.18 FEET, TO
A POINT ON THE NORTHERLY RIGHT—OF—WAY UNE OF SAID COUNTY ROAD 70;
THENCE ALONG SAID NORTHERLY RIGHT—OF—WAY LINE, SOUTH 88'38'39" WEST, A DISTANCE OF 20.00 FEET, TO
THE TRUE POINT OF BEGINNING.
SAID PARCEL CONTAINS 200 sf. OR 0.005 cc. MORE OR LESS.
THE ABOVE DESCRIPTION WAS PREPARED BY DANIEL R. HOLMES,
SURVEYOR IN AND FOR WELD COUNTY, COLORADO.
DANIEL R. HOLMES
PLS 38213
LA .
RIGHT OF WAY WELD COUNTY DEPARTMENT
1861 OF PUBLIC WORKS
ACQUISITION r ' WCR 29- HWY 392 TO WCR 74
as PROJECT
CABARUVIAS 1 1111,O�
uN T Z PROJECT NO: SFT-13 SCALE:
WELD COUNTY,COLORADO G -,—
J DATE: 8-04-25 DRAWN BY:DRH SHEET: 1 of 2
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Carly Koppes, Clerk and Recorder, Weld County , CO
EXHIBIT-A
1 I WEST ONE-QUARTER CORNER
IS9-T6N-R66W FOUND 3 1/4"
ALUMINUM CAP LS-11399
EXISTING 60' CHERYL A. CABARUVIAS
I I RIGHT OF WAY
I I RECEP. #15165 PARC.#080509000043
JANUARY 08, 1885 RECP.# 4594399, 5-29-2020
LOT-A RE-780
' 30.00' 30.00' 1� 0REC#2041013, 1-29-1986
I .1 gb
`S Ib� $�
$$41 '
I
co LINE TABLE
D
z? LINE BEARING DISTANCE
BOOTH LAND
&LIVESTOCK rn (7116,0 '
1 rn o I L1 N43'51'01"E 42.58' ,
COMPANY a' °i L2 N00'56'36"W 20.00'
as a co L3 S46'08'59"E 28.18'
cnim
-
I > 1 L4 S88'38'39"W 20.00'
I z I
c)
\ RIGHT-OF-WAY
ACQUIRED
I I \ 200 sf. OR
I I 0.005 ac.±
I SO DCP OPERATING COMPANY,LP
I ,�0 RECP.#4384990,3-22-2018
j, L
30'PIPELINE EASEMENT
L2 � .. \ -- -- -- -- - -
-- - - L4
L1
WCR 70 _ _ _
P.O.B. N88'38'39"E _ ,\ ITI
% EXISTING 60' 2656.45'
RIGHT OF WAY o
RECEP.#34224 $
OCTOBER 11, 1889
''' PS) (- SOUTHWEST CORNER SOUTH ONE-QUARTEROU CORNS
. Q. ,�,_���'•., S9-T6N-R66W FOUND 3 1/4"
S9-T6N-R66W FOUND 3 1/4" ALUMINUM CAP LS-7242
'F ' ALUMINUM CAP LS-38106, 2011
* i- rd.."IN - I \ !
�` +: I �p 1 cr 11� b MAGNUSON
s .a-05-al N I 6'f b''�b
.'' ��N.. LANd'J' 1"` 1 �1 NOTE: THIS EXHIBIT MAP DOES NOT REPRESENT A
MONUMENTED LAND SURVEY OR LAND SURVEY PLAT.
IT IS INTENDED TO ILLUSTRATE THE ATTACHED
" t PROPERTY DESCRIPTION ONLY.
RIGHT OF WAY WELD COUNTY DEPARTMENT
i 1861� OF PUBLIC WORKS
ACQUISITION
:_y_jj r ! = �1 WCR 29-HWY 392 TO WCR 74
rr PROJECT
CABARUVIAS `.� L ; 1
PROJECT NO: SFT-l3 SCALE: ] -50
WELD COUNTY,COLORADO -G 4-U N T Y
DATE:8-04-25 DRAWN BY:DRH SHEET: 2 of 2
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Carly Koppes, Clerk and Recorder, Weld County , CO
11111/PAM■a'INDI IV Mill lliki iV IA Mild 111111
1 4-44101010014
I I
1 1
I 1 P
EXISTING 60' t4 ERYL A. CABARUVIAS
RIGHT OF WAY
i IRECEP. #15165 PARC.#080509000043
I
�—JANUARY 08, 1885 RECP.# 4594399, t-29-2020
r/ LC1W!E-780'
1 30.00' 30.00' ,�, 0410f3, 1-29-,1986
Swk1 0 I r..,.+��b� I is1 �,1 kl
.
1.11
BOOTH LAND 1 ; I 1 s +le S�t��hb�
& LIVESTOCK 1 ; 1
COMPANY • Saab
I I Y 44,. t .,
I 1
it
RIGHT—OF—WA"
ACQUIRED = *
i I \ 200 sf. OR
1 1 0.005 ac.±
pp DCP OPERATING COMPANY.LP
I I ,80• RECP.#4384990.3-22-2018 M
IL\ 30'PIPELINE EASEMENT
ot t I \_ --\ __ -- - -- - - - - ____
t-
0
vIkiC iv:
a,U EXISTING 60'
RIGHT OF WAY o
RECEP. #34224 $
.. ..._,. \ _... OCTOBER 11, 1889
J •
_-' - - -- _ _ - i' SW S9-T6N-R66W--
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5068801 Pages: 8 of 8
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Carly Koppes, Clerk and Recorder, Weld County, , CO
11111 R�ra t iii.11%Iiki 1101G 111,f,�ikiiY4rh 11111
`V 1861
PUBLIC WORKS DEPARTMENT
�), vty� '� 1' = ill,vI 1111 H STREET
,r P.O. BOX 758
" GREELEY,COLORADO 80632
WEBSITE:www.weldgov.com
PHONE(970)304-6496, EXT. 3750
FAX: (970)304-6497
PERMISSION FOR ENTRY UPON REAL PROPERTY
THE UNDERSIGNED hereby gives permission for the County of Weld, its contractors,
agents, employees, and all others deemed necessary by Weld County to enter upon the following
described real property.
Identified Property:
A parcel of land said parcel being a portion of Lot-A, Recorded January 29, 1986 at
Reception No. 2041013 SW '/ of Section 9, Township 6 North, Range 66 West of the 6th
Principal Merdian,County of Weld,State of Colorado.
Also known by parcel number: 080509000043
FOR THE PURPOSE OF:
Conduct land and construction surveying and other engineering duties including
soils testing and investigations.
EXPIRES: December 31, 2026 or the end of construction,whichever is earlier.
DATE: /fI'9"2-�
NAME: Cheryl A.Cabaruvia
Signature
Print Name G r / Golorcteds
Phone: 70 f PI?6 -i/I t
Request for Taxpayer Give Form to the
Form 9(Rev.October 2018) Identification Number and Certification requester.Do not
Department of the Treasury send to the IRS.
Internal Revenue Service ►Go to www.irs.gov/FormW9 for instructions and the latest information.
1 Name(a shown o your income tax return).Name is required on this line;do not leave this line blank.
G 2
t , C rbar-0 v id'.1
2 Business namtdisregarded entity name,If different from above
m 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1.Check only one of the 4 Exemptions(codes apply only to
A following seven boxes. certain entitles,not individuals;see
a instructions on page 3):
p Individual/sole proprietor or ElC Corporation 0 S Corporation 0 Partnership ❑Trust/estate
C single-member LLC Exempt payee code(If any)
0
1§ 0 Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=Partnership)►
t; 2 Note:Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check Exemption from FATCA reporting
rta LLC if the LLC Is classified as a single-member LLC that Is disregarded from the owner unless the owner of the LLC Is code(if any)
o another LLC that is not disregarded from the owner for U.S.federal tax purposes.Otherwise,a single-member LLC that
Is disregarded from the owner should check the appropriate box for the tax classification of Its owner.
❑ Other(see Instructions)► (Applies to accounts merrrtened outside Mt,u.S)
m
M 5 Address(number,street,and apt.or suite no. See instructions. Requester's name and address(optional)
A 3 9D9-4 CoaAiy /€.acid . --f
6 City state,anciZIP code �� /
if� CO
7 Ust account nu r(s)here(optional)
Part I Taxpayer Identification Number(TIN)
Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid 1 Social security number
backup withholding.For individuals,this is generally your social security number(SSN).However,for a resident alien,sole proprietor,or disregarded entity,see the instructions for Part I,later.For other &
—
—
entities,it is your employer identification number(EIN).If you do not have a number,see How to get a
TIN,later. or
Note:If the account is in more than one name,see the instructions for line 1.Also see What Name and I Employer identification number
Number To Give the Requester for guidelines on whose number to enter.
Part II Certification
Under penalties of perjury,I certify that:
1.The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and
2.I am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue
Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am
no longer subject to backup withholding;and
3.I am a U.S.citizen or other U.S.person(defined below);and
4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct.
Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to report all Interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid,
acquisition or abandonment of secured property,cancellation of debt,contributions to an Individual retirement arrangement(IRA),and generally,payments
other than interest and dividends,you are not required o si 'certification,but you must provide your correct TIN.See the instructions for Part II,later.
SignerU.S. ersSignature of /0-/
Here u.s.person P. 'Date► V
Genera nstr ' n •Form 1099-DIV(dividends,including those from stocks or mutual
funds)
Section references are to the Internal Revenue Code unless otherwise •Form 1099-MISCvarious
noted. ( types of income,prizes,awards,or gross
proceeds)
Future developments.For the latest information about developments •Form 1099-B(stock or mutual fund sales and certain other
related to Form W-9 and its instructions,such as legislation enacted transactions by brokers)
after they were published,go to www.irs.gov/FormW9. •Form 1099-S(proceeds from real estate transactions)
Purpose of Form •Form 1099-K(merchant card and third party network transactions)
An individual or entity(Form W-9 requester)who is required to file an •Form 1098(home mortgage Interest),1098-E(student loan interest),
information return with the IRS must obtain your correct taxpayer 1098-T(tuition)
identification number(TIN)which may be your social security number •Form 1099-C(canceled debt)
(SSN),individual taxpayer identification number(FIN),adoption •Form 1099-A(acquisition or abandonment of secured property)
taxpayer identification number(ATIN),or employer identification number
(EIN),to report on an information return the amount paid to you,or other Use Form W-9 only if you are a U.S.person(including a resident
amount reportable on an information return.Examples of information alien),to provide your correct TIN.
returns Include,but are not limited to,the following. If you do not return Form W-9 to the requester with a TiN,you might
•Form 1099-INT(interest earned or paid) be subject to backup withholding.See What is backup withholding,
later.
Cat.No.10231X Form W-9(Rev.10-2018)
Coi' t tc,t 'o
Entity Information
Entity Name* Entity ID* ❑New Entity?
CABARUVIAS, CHERYL @00050394
Contract Name* Contract ID Parent Contract ID
CABARUVIAS RIGHT-OF-WAY ACQUISITION 10014
Contract Status Contract Lead* Requires Board Approval
CTB REVIEW VMINO YES
Contract Lead Email Department Project#
vmino@weld.gov SFT-13
Contract Description*
ACQUISITION OF RIGHT-OF-WAY REQUIRED FOR THE WCR 29 FROM HWY 392 TO WCR 74 ROAD IMPROVEMENT
PROJECT.
Contract Description 2
Contract Type* Department Requested BOCC Agenda Due Date
AGREEMENT PUBLIC WORKS Date* 10/25/2025
10/29/2025
Amount* Department Email
$1,300.00 CM- Will a work session with BOCC be required?*
PublicWorks@weld.gov NO
Renewable*
NO Department Head Email Does Contract require Purchasing Dept. to be
CM-PublicWorks- included?
Automatic Renewal DeptHead@weld.gov NO
NO
County Attorney
Grant GENERAL COUNTY
NO ATTORNEY EMAIL
IGA County Attorney Email
NO CM-
COUNTYATTORNEY@WEL
D.GOV
If this is a renewal enter previous Contract ID
If this is part of a MSA enter MSA Contract ID
Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts
are not in OnBase
Contract Dates
Effective Date Review Date* Renewal Date
12/31 /2025
Termination Notice Period Committed Delivery Date Expiration Date*
12/31 /2025
Contact Information
Contact Info
Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2
Purchasing
Purchasing Approver Purchasing Approved Date
Approval Process
Department Head Finance Approver Legal Counsel
.CURTIS HALL RUSTY WILLIAMS BYRON HOWELL
DH Approved Date Finance Approved Date Legal Counsel Approved Date
10/22/2025 10/22/2025 10/22/2025
Final Approval
BOCC Approved Tyler Ref#
AG 102725
BOCC Signed Date Originator
VMINO
BOCC Agenda Date
10/27/2025
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