Certification For Personal Services Agreement Page 3
Download a blank fillable Certification For Personal Services Agreement in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Certification For Personal Services Agreement with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3THE FOLLOWING TO BE COMPLETED BY HR REPRESENTATIVE ONLY
1. I attest that the acquisition of services from the independent contractor will not directly or indirectly
result in the separation or displacement of classified state employees within the state personnel
system.
No
Yes
2. Have these outsourced services presently or previously been performed within the state personnel
system? If the contract is over $100,000, then please complete the PSA task within CMS.
No
Yes
If yes, provide the following within CMS PSA Task.
C.R.S 24-102-205 requires that all departments are to use the centralized Contract
Management System (CMS) to track the number of employment positions that are filled
and/or eliminated under any personal services contract that was previously performed by
classified state employees. The business case and cost analysis must support a cost savings
and show at least equal or increased quality of the service being outsourced, and be
documented and approved within the CMS PSA Task.
Review/Approval Criteria: The following are statutory criteria by which personal services
agreements will be evaluated by the State Personnel Director or designee. Please identify those
criteria that apply to approve this request.
Solicitation provisional approval. To meet statutory criteria, final personal services review and approval is
o
required upon award of the solicitation and before the agreement is executed.
The contract meets the relevant cost savings test. A “Cost Comparison” form must be completed and
o
attached to this form. C.R.S. 24-50-503
The contract is for a new state program (created after 4/7/93), which statutorily authorizes the
o
performance of the program by independent contractors. C.R.S. 24-50-504(2)(b)
The contracted services are not available within the state personnel system, or cannot be performed
o
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.
o
24-50-504(2)(d)
The contract is needed to protect against a conflict of interest, or to ensure independent and unbiased
o
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
o
provided by the State in the location where the services are to be performed. C.R.S. 24-50-504(2)(f)
The contractor will conduct training courses for which appropriately qualified state personnel system
o
instructors are not available. C.R.S. 24-50-504(2)(g)
The services are of an urgent, temporary, or occasional nature. C.R.S. 24-50-504(2)(h)
o
The contract is for purchased services. (The acquisition of services that directly benefit specific groups or
o
individuals in the public at large). C.R.S. 24-50-504(3)
The services provided are for a term of six months or less and are not expected to recur on a regular
o
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 contractor 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) and supporting documentation.
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:
Personal Services PCP Certified Human Resource Representative
Title/Work Phone Number
Revised document DPA/DHR 7/2010
ADVERTISEMENT
0 votes
Related Articles
Related forms
Form It-2104-ms - New York State Withholding Exemption Certificate For Military Service Personnel
Financial
Form It-2104-ms - New York State Withholding Exemption Certificate For Military Service Personnel
Financial
Form It-2104-ms - New York State Withholding Exemption Certificate For Military Service Personnel
Financial
Related Categories
Parent category: Business