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Home My WebLink About20150167.tiff RESOLUTION RE: APPROVE LEASE AGREEMENT FOR TEMPORARY OFFICE SPACE (822 7TH STREET, SUITE 9, GREELEY) AND AUTHORIZE CHAIR TO SIGN - OFFICE OF REPRESENTATIVE KEN BUCK 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 Lease Agreement for Temporary Office Space at 822 7th Street, Suite 9, Greeley, Colorado 80631, between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, and the Office of Representative Ken Buck, commencing January 16, 2015, and ending June 15, 2015, with further terms and conditions being as stated in said lease agreement, and WHEREAS, after review, the Board deems it advisable to approve said lease agreement, a copy of which is attached hereto and incorporated herein by reference, conditional upon receipt of a signed original consistent with the content as provided. NOW, THEREFORE, BE IT RESOLVED by the Board of County Commissioners of Weld County, Colorado, that the Lease Agreement for Temporary Office Space at 822 7th Street, Suite 9, Greeley, Colorado 80631, between the County of Weld, State of Colorado, by and through the Board of County Commissioners of Weld County, and the Office of Representative Ken Buck be, and hereby is, conditionally approved. BE IT FURTHER RESOLVED by the Board that the Chair be, and hereby is, authorized to sign said lease agreement upon receipt. The above and foregoing Resolution was, on motion duly made and seconded, adopted by the following vote on the 12th day of January, A.D., 2015. BOARD OF COUNTY COMMISSIONERS WELD COUNTY, C LORADO ATTEST: ��jj C� s4 / , �CLLD arbara Kirkmey r, Chair / Weld County Clerk to the Board Mi e Freeman, Pro-Tem BY: D-pty Clerk to the r Sean P. Conway APPROVED AS TO F Nil t ,••'•,• le A. oza Coun y Attorney`/ 7 ��...� Steve Moreno Date of signature: ,.II CC 56 err) 424, 2015-0167 BC0048 District Office Lease Attachment- Instructions The District Office Lease Attachment is a 4-page document that must accompany every Lease or District Office Lease Amendment that is submitted for a Member/Member-Elect's 1)istrict Office. NO LEASE,AMENDMENT OR ATTACHMENT CAN BE SIGNED BEFORE THEY HAVE BEEN APPROVED BY THE ADMINISTRATIVE COUNSEL. The term of a District Office Lease or Amendment for the 114th Congress may not commence prior to January 3,2015. Members should endeavor to lease space through the last day of a congressional term rather than the last day of a calendar year. For the 114`"Congress,leases should end on January 2,2017,not December 31,2016. Four things are required: 1. the signature of the Landlord and date: 2. the signature of the Member/Member-Elect of Congress and date; 3. contact information for the person in the Member/Member-Elect's office whom we should call if there are any problems or questions(scheduler,etc.);and 4. the signature from the Office of the Administrative Counsel. A few things to keep in mind: A. The Member/Member-Elect is required to personally sign the documents. B. The Attachment SHALL NOT have any provisions deleted or changed. C. Even if rent is zero,an Attachment is still required. D. Prior to either party signing a Lease or Amendment,the Member/Member-Elect must submit the proposed Lease or Amendment,accompanied by a copy of the Attachment,to the Administrative Counsel for review and approval. If the Administrative Counsel determines that the proposed terms and conditions of the Lease or Amendment are in compliance with applicable law and House Rules and Regulations, the Administrative Counsel will notify the Member/Member-Elect that(s)he may proceed with the execution of the Lease or Amendment. Please submit the proposed Lease or Amendment and Attachment either by e-mail in PDF form (leases@mail.house.gov)or by fax(202-225-6999). E. Once signed by both parties,the Lease or Amendment and the Attachment must be submitted to the Administrative Counsel for final approval. The Attachment should be submitted at the same time the Lease or Amendment is sent to the Administrative Counsel. They may be sent by email in PDF form or faxed to(202-225-6999),but the originals still must be submitted by interoffice mail (217 Ford House Office Building,Washington,D.C.20515)after emailing or faxing. F. Without a properly signed and submitted Attachment,the Lease or Amendment cannot be approved and payments will not be made. The parties agree that any charges for default,early termination or cancellation of the Lease or Amendment which result from actions taken by or on behalf of the Lessee shall be the sole responsibility of the Lessee,and are not reimbursable from the Member's Representational Allowance. G. Lessor shall provide a copy of any assignment,estoppel certificate,notice of a bankruptcy or foreclosure,or notice of a sale or transfer of the leased premises to the Administrative Counsel by e-mail in PDF form (leases@mail.house.gov). 2015-0167 V.S. grouse of representatives Washington. D.C.20515 District Office Lease (Page 1 of 3—114'"Congress) Pursuant to 2 UJ.S.C.A. §4313,and the Regulations of the Committee on House Administration(as modified from time to time by ommittee Order)relating to office sp e in home districts, _� W e,! CoCJndt ,Al50 - S.fRe�. I (_andlord's name) J n (Landlord's street address,city,sta e,ZIP code) ("Lessor"),and 4 e A (3,,C k .a Member/Member-Elect of the U.S.House of Representatives("Lessee"),agree as follows: 1. Location. l.es or shall lease to Lessee_ '73' square feet of office space located at a 1 0, .54rt'Q_-t. Stl,1e. —� (Office street address) in the city,state and ZIP code of 6-/+C P e (G ,; P O 3 >' (Office ��ty,state and ZIP) 2. Lease Amenities.Note that this checklist is for convenience only and the listed amenities are not required. However,the interior wiring of a CAT 5e or better and broadband Internet access to the building will likely expedite the process for the office to be fully operational. DO'tlil The Lease includes(please check any and complete ail that apply): Wei 1111� Telephone Service Available. (interior wiring CAT Se or better)v' 3 A fug t,,.'►is nBroadband Internet Access to Building. (e.g.,COMCAST,COX or like provide ['Parking.❑*no.of assigned parking spaces O 0 no. of unassigned parking spaces n General off-street parking on an as available basis Utilities. Includes: (t m, IL $6wer 1 U .o i f/ cd" c-(1t-; / Janitorial Services. Frequency: 5 times pe a. Trash Removal. Frequency: o c cjrx�c pi ^ (Carpet Cleaning. Fre nry• Window Washing Window Treatments i!) r-ho-ti Tenant Alterations Included In Rental Rate. After Hours Building Access. ['office Furnishings. Includes: [Cable TV Accessible. If checked.Included in Rental Rate© YesfNo Building Manager. Onsite IglOn Call Contact Name: Sc.n c{ . (2 ID rc 1a r k Phone Number('O) k6Gj- /7 ISEmail Address: 5'r.tnr,!rex . (:Icr'k ct d 4-Z•c_oin 3. Term. Lessee shall have and hold the leased premises for the period beginning Jail / 6 , 20 j c and ending,)ftiy1 e 15 ,20 15. The term of this District Office Lease("Lease") may not exceed two(2)years and may not extend beyond January 2,2017,which is the end of the constitutional term of the Congress to which the Member is elected. 4. Rent. The monthly rent shall be 30O , 00- _,and is payable in arrears on or before the last day of each calendar month. Rent payable under this Lease shall be prorated on a daily basis for any fraction of a month of occupancy. 21.5. Rouse of Wfpresentalives Washington, D.C.20515 District Office Lease (Page 2 of 3—114`'Congress) 5. Early Termination. This Lease may be terminated by either party giving 30 days' prior written notice to the other party. The commencement date of such termination notice shall be the date such notice is delivered or,if mailed,the date such notice is postmarked. 6. Payments. During the term of this Lease,rent payments under Section 4 of this Lease shall be remitted to the Lessor by the Chief Administrative Officer of the U.S. House of Representatives (the"CAO")on behalf of the Lessee. 7. District Office Lease Attachment for 114th Congress. The District Office Lease Attachment attached hereto is incorporated herein by reference,and this Lease shall have no force or effect unless and until accompanied by an executed District Office Lease Attachment for the 114th Congress. 8. Counterparts. This Lease may be executed in any number of counterparts and by facsimile copy,each of which shall be deemed to be an original but all of which together shall be deemed to be one and the same instrument. 9. Section Headings. The section headings of this Lease are for convenience of reference only and shall not he deemed to limit or affect any of the provisions hereof. 10. Modifications. Any amendments,additions or modifications to this Lease inconsistent with Sections 1 through 9 above shall have no force or effect to the extent of such inconsistency. it. Other. Additionally,the Lessor and the Lessee agree to the following: N/A (Signature page follows.] 'U.S. Yfouse of Representatives Washington, D.C.20515 District office lease (Page 3 of 3— 11 A'"Congress) IN WITNESS WHEREOF, the parties have duly executed this District Office Lease as of the later date written below by the Lessor or the Lessee. Weld_County Comm1 stoners S.t - FolIQttitm ?� Print Name of Lessor/Landlo &Company Print amt erf Lessee 8y Lcssnr Si attire Lessee Signature Name: Barbara Kirkmeyer Title: Chair JAN 1 2 2015 Date Date This District Office Lease must be accompanied with an executed District Office Lease Attachment. (720/5- D/L 1 VS. :Rouse of Rspresentatrves Washington, }as hington�7D.CC..20515 µt (Page 3 of 3-11a^Congress) IN WITNESS WHEREOF, the parties have duly executed this District Office Lease as of the later date written below by the Lessor or the Lessee. Weld County Commi sal(mars__ �`e &u.C Print Name gf Lessa/Landlo d'Conrpaty Print Name of Lessee ilidau Lessor Si attire Lessee Signature Name: Barbara Kirkmeyer Title: Chair JAN I22015 O///2/2015 Date Date This District Office Lease must he accompanied with an executed District Office Lease Attachment. District Office Lease Attachment- Instructions The District Office Lease Attachment is a 4-page document that must accompany every Lease or District Office Lease Amendment that is submitted for a Mcmher/Member-Elect's District Office. NO LEASE,AMENDMENT OR ATTACHMENT CAN BE SIGNED BEFORE THEY HAVE BEEN APPROVED BY THE ADMINISTRATIVE COUNSEL. The term of a District Office Lease or Amendment for the 114"'Congress may not commence prior to January 3,2015. Members should endeavor lo lease space through the last day of a congressional term rather than the last day of a calendar year. For the 114th Congress,leases should end on January 2,2017,not December 31,2016. Four things are required: 1. the signature of the Landlord and date; 2. the signature of the Member/Member-Elect of Congress and date; 3. contact information for the person in the Member/Member-Elect's office whom we should call if there are any problems or questions(scheduler,etc.);and 4. the signature from the Office of the Administrative Counsel. A few things to keep in mind: A. The Member/Member-Elect is required to personally sign the documents. B. The Attachment SHALL NOT have any provisions deleted or changed. C. Even if rent is zero,an Attachment is still required. D. Prior to either party signing a Lease or Amendment,the Member/Member-Elect must submit the proposed Lease or Amendment,accompanied by a copy of the Attachment,to the Administrative Counsel for review and approval. If the Administrative Counsel determines that the proposed terms and conditions of the Lease or Amendment are in compliance with applicable law and House Rules and Regulations,the Administrative Counsel will notify the Member/Member-Elect that(s)he may proceed with the execution of the Lease or Amendment. Please submit the proposed Lease or Amendment and Attachment either by e-mail in PDF form (leases(cbmail.house.gov)or by fax(202-225-6999). E. Once signed by both parties,the Lease or Amendment and the Attachment must be submitted to the Administrative Counsel for final approval. The Attachment should be submitted at the same time the Lease or Amendment is sent to the Administrative Counsel. They may be sent by email in PDF form or faxed to(202-225-6999),but the originals still must be submitted by interoffice mail (217 Ford House Office Building,Washington,D.C.20515)after cmailing or faxing. F. Without a properly signed and submitted Attachment,the Lease or Amendment cannot be approved and payments will not be made. The parties agree that any charges for default,early termination or cancellation of the I.ease or Amendment which result from actions taken by or on behalf of the Lessee shall be the sole responsibility of the Lessee,and are not reimbursable from the Member's Representational Allowance. G. Lessor shall provide a copy of any assignment,estoppel certificate, notice of a bankruptcy or foreclosure,or notice of a sale or transfer of the leased premises to the Administrative Counsel by e-mail in PDF form (leases@mail.house.gov). mstrict Office Lease -Instructions NO LEASE OR ATTACHMENT CAN BE SIGNED BEFORE THEY HAVE BEEN APPROVED BY THE ADMINISTRATIVE COUNSEL. The term for a District Office Lease for the 114"'Congress may not commence prior to January 3,2015. Members should endeavor to lease space through the last day of a congressional term rather than the last day of a calendar year. For the 114"'Congress,leases should end on January 2, 2017, not December 31,2016. A. The preamble has three blank lines to be filled in: (I)Landlord's name;(2)Landlord's address; and(3)Member/Member-Elect's name. B. Section 1 has three blank lines to be filled in: (1)square footage of the leased office(optional); (2)street address of the leased office;and(3)city,state and ZIP code of the leased office. C. Section 2 has boxes that can be checked on whether any lease amenities(such as parking, utilities,janitorial services,trash removal,etc.)are included in the lease. Note that this checklist is only for convenience and the listed amenities are not required. Some of the options have a blank line to be filled in to provide additional information about an amenity. D. Section 3 has two blank lines to be filled in: (I)date lease begins(must be on or after January 3, 2015);and(2)date lease ends(must be on or before January 2,2017). E. Section 4 has one blank line for the monthly rent amount(write"zero"if no rent is to be paid). F. Section 5 has one blank line—the number of days' notice required for either party to terminate the lease before the end of the term. A standard period is 30 days,but any figure is acceptable. If the lease may not be terminated early,enter"N/A"in this blank. G. Sections 1-9,other than filling in the blanks,may not be altered or deleted. H. Section 11 has space provided to list any additional lease provisions. I. Prior to either party signing a lease,the Member/Member-Elect must submit the proposed lease, accompanied by a copy of the District Office Lease Attachment for the 114`h Congress,to the Administrative Counsel for review and approval. If the proposed terms and conditions of the lease are determined to be in compliance with applicable law and House Rules and Regulations, the Administrative Counsel will notify the Member/Member-Elect that(s)he may proceed with the signing of the lease. Please submit the proposed lease and District Office Lease Attachment either by e-mail in PDF form(leases@mail.house.gov)or fax(202-225-6999). J. The Member/Member-Elect is required to personally sign the documents. A signed and dated District Office Lease Attachment must accompany this lease. Once signed by both parties,the Lease and the District Office Lease Attachment must be submitted to the Administrative Counsel for final approval. They may be sent by email in PDF form or faxed to 202-225-6999, but the originals still must be submitted by inter office mail(217 Ford House Office Building, Washington,D.C.20515)after emailing or faxing. K. If approved, Administrative Counsel will send the forms to Finance so that payment can begin. If there are errors on the form,the Member office will be contacted and required to correct them. .grouse of Representatives Washington,D.C.20515 District Office Lease Attachment (Page 1 of 4— 114`'Congress) I. Incorporated District Office Lease Attachment. Lessor(Landlord)and Lessee (Member/Member-Elect of the U.S. House of Representatives)agree that this District Office Lease Attachment("Attachment")is incorporated into and made part of the Lease("Lease")and, if applicable, District Office Lease Amendment(`'Amendment")to which it is attached. 2. Performance. Lessor expressly acknowledges that neither the U.S. House of Representatives (the"House")nor its Officers are liable for the performance of the Lease. Lessor further expressly acknowledges that payments made by the Chief Administrative Officer of the I louse (the"CAO")to Lessor to satisfy Lessee's rent obligations under the Lease—which payments are made solely on behalf of Lessee in support of his/her official and representational duties as a Member 0i-the House—shall create no legal obligation or liability on the part of the CAO or the 1-louse whatsoever. Lessee shall be solely responsible for the performance of the Lease and Lessor expressly agrees to look solely to Lessee for such performance. 3. Modifications. Any amendment to the Lease must be in writing and signed by the Lessor and Lessee. Lessor and Lessee also understand and acknowledge that the Administrative Counsel for the CAO(`'Administrative Counsel")must review and give approval of any amendment to the Lease prior to its execution. 4. Compliance with House Rules and Regulations. Lessor and Lessee understand and acknowledge that the Lease shall not be valid,and the CAO will not authorize the disbursement of funds to the Lessor,until the Administrative Counsel has reviewed the Lease to determine that it complies with the Rules of the House and the Regulations of the Committee on House Administration,and approved the Lease by signing on page 4 of this Attachment. 5. Payments. The Lease is a fixed term lease with monthly installments for which payment is due in arrears on or before the end of each calendar month. In the event of a payment dispute, Lessor agrees to contact the Office of Finance of the House at 202-225-7474 to attempt to resolve the dispute before contacting Lessee. 6. Void Provisions. Any provision in the Lease purporting to require the payment of a security deposit shall have no force or effect. Furthermore,any provision in the Lease purporting to vary the dollar amount of the rent specified in the Lease by any cost of living clause,operating expense clause,pro rata expense clause,escalation clause,or any other adjustment or measure during the term of the Lease shall have no force or effect. 7. Certain Charges. The parties agree that any charge for default,early termination or cancellation of the Lease which results from actions taken by or on behalf of the Lessee shall be the sole responsibility of the Lessee,and shall not be paid by the CAO on behalf of the Lessee. 8. Death,Resignation or Removal. In the event Lessee dies,resigns or is removed from office during the term of the Lease,the Clerk of the House may,at his or her sole option,either:(a) terminate the Lease by giving thirty(30)days' prior written notice to Lessor;or(b)assume the obligation of the Lease and continue to occupy the premises for a period not to exceed sixty(60) days following the certification of the election of the Lessee's successor. In the event the Clerk elects to terminate the Lease,the commencement date of such thirty(30)day termination notice shall be the date such notice is delivered to the Lessor or,if mailed,the date on which such notice is postmarked. V.S. grouse of&presentatives Washington,D.C.20515 District Office tease Attachment (Page 2 of 4— 114"'Congress) 4. Term. The term of the Lease may not exceed the constitutional term of the Congress to which the Lessee has been elected. The Lease may be signed by the Member-Elect before taking office. Should the Member-Elect not take office to serve as a Member of the 114t Congress,the Lease will be considered null and void. 10. Early Termination. If either Lessor or Lessee terminates the Lease under the terms of the Lease, the terminating party agrees to promptly file a copy of any termination notice with the Office of Finance,U.S. House of Representatives,8-245 Longworth House Office Building,Washington. D.C.20515.and with the Administrative Counsel by e-mail at leases@mail.house.gov. 11. Assignments. Lessor shall not have the right to assign(by operation of law or otherwise)any of its rights, interests and obligations under the Lease, in whole or in part,without providing thirty (30)days prior written notice to Lessee,and any such purported assignment without such notice shall be void. Lessor shall promptly file a copy of any such assignment notice with the Administrative Counsel by e-mail at leases(cr@.mail.house.gov. 12. Sale or Transfer of Leased Premises, Lessor shall provide thirty(30)days prior written notice to Lessee in the event(a)of any sale to a third party of any part of the leased premises,or(b) Lessor transfers or otherwise disposes of any of the leased premises.and provide documentation evidencing such sale or transfer in such notice. Lessor shall promptly file a copy of any such sale or transfer notice with the Administrative Counsel by e-mail at leases@mail.house.gov. 13. Bankruptcy and Foreclosure. in the event(a)Lessor is placed in bankruptcy proceedings (whether voluntarily or involuntarily),(b)the leased premises is foreclosed upon,or(c)of any similar occurrence, Lessor agrees to promptly notify Lessee in writing. Lessor shall promptly file a copy of any such notice with the Office of Finance,U.S. House of Representatives,B-245 Longworth House Office Building, Washington,D.C.20515,and with the Administrative Counsel by e-mail at leases@mail.house.gov. 14. Estoppel Certificates. Lessee agrees to sign an estoppel certificate relating to the leased premises(usually used in instances when the Lessor is selling or refinancing the building)upon the request of the Lessor. Such an estoppel certificate shall require the review of the Administrative Counsel,prior to Lessee signing the estoppel certificate. Lessor shall promptly provide a copy of any such estoppel certificate to the Administrative Counsel by e-mail at le asesla?mai l.ho use.gov. 15. Maintenance of Common Areas. Lessor agrees to maintain in good order,at its sole expense, all public and common areas of the building including,but not limited to,all sidewalks,parking areas,lobbies,elevators,escalators,entryways,exits,alleys and other like areas. 16. Maintenance of Structural Components. Lessor also agrees to maintain in good order, repair or replace as needed,at its sole expense,all structural and other components of the premises including,but not limited to,roofs,ceilings,walls(interior and exterior), floors,windows,doors, foundations,fixtures,and all mechanical,plumbing,electrical and air conditioning/heating systems or equipment(including window air conditioning units provided by the Lessor)serving the premises. V S. .7louse of ftpresentatives Washington. D.C. 20515 District Office Lease Attachment (Page 3 of 4-114r Congress) 17. Lessor Liability for Failure to Maintain. Lessor shall be liable for any damage,either to persons or property,sustained by Lessee or any of his or her employees or guests,caused by Lessor's failure to fulfill its obligations under Sections 15 and 16. 18. Initial Alterations. Lessor shall make any initial alterations to the leased premises,as requested by Lessee and subject to Lessor's consent,which shall not be unreasonably withheld. The cost of such initial alterations shall be included in the annual rental rate. 19. Federal Tort Claims Act. Lessor agrees that the Federal Tort Claims Act,28 U.S.C. §§2671- 80, satisfies any and all obligations on the part of the Lessee to purchase private liability insurance. Lessee shall not he required to provide any certificates of insurance to Lessor. 20. Limitation of Liability. Lessor agrees that neither Lessee nor the House nor any of the House's officers or employees will indemnify or hold harmless Lessor against any liability of Lessor to any third party that may arise during or as a result of the Lease or Lessee's tenancy. 21. Compliance with Laws. Lessor shall be solely responsible for complying with all applicable permitting and zoning ordinances or requirements,and with all local and state building codes, safety codes and handicap accessibility codes(including the Americans with Disabilities Act), both in the common areas of the building and the leased space of the lessee. 22. Electronic Funds Transfer. Lessor agrees to accept monthly rent payments by Electronic Funds Transfer and agrees to provide the Office of Finance,U.S. House of Representatives,with all banking information necessary to facilitate such payments. 23. Refunds. Lessor shall promptly refund to the CAO,without formal demand,any payment made to the Lessor by the CAO for any period for which rent is not owed because the Lease has ended or been terminated. 24. Conflict. Should any provision of this Attachment be inconsistent with any provision of the attached Lease or attached Amendment,the provisions of this Attachment shall control,and those inconsistent provisions of the Lease or the Amendment shall have no force and effect to the extent of such inconsistency. 25. Construction. Unless the clear meaning requires otherwise,words of feminine,masculine or neuter gender include all other genders and,wherever appropriate,words in the singular include the plural and vice versa. 26. Fair Market Value. The Lease or Amendment is entered into at fair market value as the result of a bona fide,arms-length,marketplace transaction. The Lessor and Lessee certify that the parties are not relatives nor have had,or continue to have,a professional or legal relationship (except as a landlord and tenant). 27. District Certification. The Lessee certifies that the office space that is the subject of the Lease is located within the district the Lessee was elected to represent unless otherwise authorized by Regulations of the Committee on House Administration. `�.S. Rouse of Representatives Washington.D.C.20515 District Office lease Attachment (Page 4 of 4— 114w Congress) 28. Counterparts. This Attachment may be executed in any number of counterparts and by facsimile copy,each of which shall be deemed to be an original but all of which together shall be deemed to be one and the same instrument. 29. Section Headings. The section headings of this Attachment are for convenience of reference only and shall not be deemed to limit or affect any of the provisions hereof. IN WITNESS WHEREOF,the parties have duly executed this District Office Lease Attachment as of the later date written below by the Lessor or the Lessee. Weld County Commissioners Print Name of Lessor/Landlord Print Name of Lessee By: Lessor Signature Lessee Signature Nance: Barbara Kirkmeyer Title: Chair JAN 1 2 2015 __... Dale Date From the Member's Office,Nh is the point of contact for questions? same Phone( _)_- E-mail _@mail.house.gov This District Office Lease Attachment and the attached Lease or Amendment have been reviewed and are approved,pursuant to Regulations of the Committee on House Administration. Signed _ -- Date_._. .. ,20 (Administrative Counsel) Send completed forms to:,administrative Counsel,217 Ford House Office Building. Washington.D.C.20515. Copies may also be faxed to 202-225-6999. 1, `�S• House of Representatives Washington.D.C.20515 District once Lease Attachment (Page 4 of 4--114a Congress) 28. Counterparts. This Attachment may be executed in any number of counterparts and by facsimile copy,each of which shall be deemed to be an original but all of which together shall be deemed to be one and the same instrument. 29. Section Headings. The section headings of this Attachment are for convenience of reference only and shalt not be deemed to limit or affect any of the provisions hereof. IN WITNESS WHEREOF,the panics have duly executed this District Office Lease Attachment as of the tater date written below by the Lessor or the 1.essee. Weld County Commissinnera_ - f l ( C k Print Nance of Lessor/Lundl rd Print Name of Lessee By: - Zbt_VIC Lessor Signatur Lessee Signature Name: Barbara Kirkmeyer Title: Chair. JAN 1 2 2015 1/12/20/3 Date Date from the Member's Office,who is the print of contact for questions? Name Phone(--)_ E-mail _ @mail.house.gov This District Office Lease Attachment and the attached Lease or Amendment have been reviewed and are approved,pursuant to Regulations of the Committee on House Administration. Signed--- _. Date T�_....._._� ,20 —(Administrative Counsel) b,3-rCI ac;<<6re7 3,O ),, 2 0 z_ - 74/0 - Isis I p ropil ��,Y,c:r �,�,wsc Send compterrd.frrrrns tot Admmutrarive counsel,217 Ford House Office Building, Washington,D.C.20515. Copies may also be fared to 202-225-6999. U.S. Mouse of Representatives Substitute W-9 and ACH Vendor/Miscellaneous Payment Enrollment Form Internal Revenue Code 6109,31 U.S.C.3322,31 CFR 210 and the 1996 Debt Collection Improvement Act require all entities that do business with the United States Government to provide a Tax Identification Number(TIN)and Electronic Funds Transfer(EFT infornation for payment. PL 93-579 protects your privacy and mandates that the information never be published or used for any other purpose than to pay you. Please complete all sections below,sign and return via Me email or fax number listed, RETURN FORM TO: — VendorEFTIIDmail.house.gov FAX NUMBER: (202)2254914 SECTION UNITED STATES HOUSE OF REPRESENTATIVES INFORMATION ADDRESS US HOUSE OF REPRESENTATIVES-ACCOUNTING,31000'NEILL FEDERAL BUILDING.WASHINGTON,DC 20515 AGENCY IDENTIFIER 53-6002523 AGENCY LOCATION CODE 4832 TELEPHONE NUMBER(202)22&2277 SECTION II PAYEE/COMPANY INFORMATION NAME(AS SHOWN ON YOUR INCOME TAX RETURN) CHECK APPROPRIATE BOX FOR FEDERAL TAX CLASSIFICATION(required) O Individual( Sole ❑C Corporation ❑S Corporation❑Partnership ❑TruetiEatate Proprietor BUSINESS NAME,Di SRE CARDED ENTITY NAME on DBA.IF DIFFERENT THAN ABOVE Limited Liability Company Enter tax classification I Exempt ❑ payee I I (C=C corporation,S=S corporation,P=Partnership) -- OF TAX IDENTIFICATION NUMBER ENTER TAX IDENTIFICATION NUMBER O OTHER(Other entities.Enter your business name beow as shown on required federal tax SOCIAL ScCURITY Nt."M9FR(cr) documents Name'line,This name should match the name shown on the charter or other legal SIN document creating the entity.You may enter any business,trade,or OBA name on the'Business ---........ — nameidisrega dee entity name*We.) ADDRESS/CITYISTATEUZIP PURCHASE ORDER ADORESSfCTTY/STATE/ZIP CONTACT PERSON NAME EMAIL EMAIL - TELEPHONE NUMBER ]FAX NUMBER TELEPHONE NUMBER FAX NUMBER I REMIT TO ADDRESS SECTION III FINANCIAL INSTITUTION INFORMATION BANK NAME(Branch City,State) _ ACH COORDINATOR NAME TELEPHONE NUMBER NINE-DIGIT ROUTING TRANSIT NUMBER DEPOSITOR ACCOUNT TITLE DEPOSITOR ACCOUNT NUMBER rL B XNUMBER TYPE OF ACCOUNT --- flCHECKING SAVINGS ❑ LOCKBOX --- - ------- - SECTION IV SOCIO-ECONOMIC INFORMATION Type of Business in Large Business-No Socio-Econornfc Designations ❑Minordy❑SmBushtess ❑Sm-D 5adv/Mmorlly ❑Sm-Dsedv Only O SmMin Only Sm-Disadvantaged Business Prog ❑8(a)Firm HUBZone Program ❑HUBZone Eligible El Emerging Small Business i ❑Women-Owned Business Other Preference Programs In Buy Indian In Directed to JWOD Non-Profit riNo Preference/Not Listed ❑Smal Business Set-Aside ❑Very Small Business Set-Aside Veteran Owned Status O Non-Vet Owned SmBus❑Other Vet Owned SmBus ❑Sere-Disabled Vet Other Bus❑Serv-Disabled Vet Owned SB❑Vet-Owned Other Bus Size of Business — O(A)50 or less ❑(e)51.100 ❑(C)101-25O ❑(D)251-500 in(E)501.750Q(A)751.1.000 1:1(G)Over 1,000 0(114)1 million or less ❑(N)1.1.2 million ❑(P)2.1.3.5 million f(R)3.1.5 million O(S)51.10 mullion ❑(r)10.1-17 meson O(Z)Oven 17 million SECTION V CERTIFICATION OF DATA BY PAYEE/COMPANY NAME 1TITLE/POSITION SIGNATURE DATE TELEPHONE NUMBER USit 2013 vI Instructions for Completing U.S. House of Representatives Substitute W-9 and ACH Vendor/Miscellaneous Payment Enrollment Form Section I -Agency Information—Includes the name and address, agency identifier, agency location code and telephone number for the House of Representatives. Section II -Payee/Company Information—Print or type the name of the payee/company and address that will receive payment, social security or taxpayer ID number, contact person name,telephone number and email of the payee/company. Print or type the purchase order and remit to addresses if different from the payee/company address. Check the appropriate boxes for federal tax classification. • Section III -Financial Institution Information —Print or type the name and address of the payee/company's financial institution who will receive the ACH payment,ACH coordinator name and telephone number, nine-digit routing transit number, depositor(payee/company)account title and account number. Check the appropriate box for type of account. Payee/Company may include a voided check with this form. ACH Account information Located on a Check or Deposit Ticket FINANCIAL INSTITUTION NAME name of the financial institution to which the payments are to be directed ROUTING TRANSIT NUMBER(RTN) financial institution's 9 digit routing transit number; found on the bottom of a check or deposit ticket or from your Financial Institution ACCOUNT TITLE employee's or vendor's name on the account ACCOUNT NUMBER account number at the financial institution 1. Routing Transit Number(RTN) —nine digits located between THOMAS B.ANDERSON 101 two symbols. This number r23PtEA.WIT STACEY identifies the bank holding your WAIIIEN,FL t?St5 M•tyb account and check processing center. i'A1'Ill , $ 2. Account number—this is your i :r , l•, ,q complete account number. • + = Your account number can be - up to 17 digits. Please include C ISM SIMPLE VOID leading zeros. .7 �a+Ara,t000w+ 5YnTrust 3. ACH Routing Transit Number— Automated Clearing House ip routing number, use this 1:0000000001: 2 3 4 5 6?8 900' 0101 number for your Routing Transit Number(RTN)if you `;", — ``' �� s • '__..._ ! ` ''_ -:Y� bank with SunTrust Bank. 4. Check number—This 1 2 3 4 information is not necessary- do not provide Section IV-Socio-Economic Information—Check the boxes for each category, if applicable:type of business, small disadvantaged business program, HUBZone program, emerging small business, women-owned business, other preference programs,Veteran owned status and size of business. Detailed information related to Small Business programs can be found at http://www.sba.gov/. Section V-Certification of Data By Payee/Company—Print or type the name,title/position and phone number of the Authorized official. The Authorized official must sign and date the form. Hello