Form PCS-1 "Professional Consultant Services Contract" - Arkansas

Form PCS-1 Printable Pdf
Download pdf Fill PDF online

What Is Form PCS-1?

This is a legal form that was released by the Arkansas Department of Finance & Administration - a government authority operating within Arkansas. Check the official instructions before completing and submitting the form.

Form Details:

  • Released on April 1, 2016;
  • The latest edition provided by the Arkansas Department of Finance & Administration;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form PCS-1 by clicking the link below or browse more documents and templates provided by the Arkansas Department of Finance & Administration.

ADVERTISEMENT
ADVERTISEMENT

Download Form PCS-1 "Professional Consultant Services Contract" - Arkansas

875 times
Rate (4.6 / 5) 61 votes
Show Pagination
STATE OF ARKANSAS
PROFESSIONAL CONSULTANT SERVICES CONTRACT
CONTRACT #
FEDERAL I.D. #
YES 
NO 
VENDOR #
MINORITY VENDOR
1. PROCUREMENT:
Check ONE appropriate box below for the method of procurement for this contract:
 ABA Criteria
 Request for Proposal
 Competitive Bid
 Request for Qualifications
 Intergovernmental
 Emergency
 Invitation for Bid
 Cooperative Contract
 Small Order
 Sole Source by Justification
 Sole Source by Intent to Award
(Justification must be attached)
 Sole Source by Law - Act #
or Statute #:
 Exempt by Law
 Special Procurement
2. TERM DATES:
The term of this agreement shall begin on
and shall end on
.
(mm/dd/yyyy)
(mm/dd/yyyy)
3. CONTRACTING PARTIES:
State of Arkansas is hereinafter referred to as the agency and contractor is herein after referred to as the Vendor.
AGENCY NUMBER & NAME
Service Bureau
VENDOR NAME
VENDOR ADDRESS
TRACKING # 1
TRACKING # 2
4A. TOTAL PROJECTED CONTRACT COST:
Total Projected Cost of entire project if all available extensions of this contract are
$
completed (up to the date anticipated and stated in Section 13)
4B. CALCULATIONS OF COMPENSATION:
For work to be accomplished under this agreement, the Vendor agrees to provide the personnel at the rates
scheduled for each level of consulting personnel as listed herein. Calculations of compensation and reimbursable
expenses shall only be listed in this section. If additional space is required, a continuation sheet may be used as
an attachment.
LEVEL OF
NUMBER
COMPENSATION
TOTAL FOR
PERSONNEL
RATE
LEVEL
Total compensation exclusive of expense reimbursement
$
REIMBURSABLE EXPENSES
ESTIMATED
TOTAL
ITEM (Specify)
RATE OF REIMB.
Total reimbursable expenses
$
Total compensation inclusive of expense reimbursement
$
FORM PCS-1
Page 1 of 5
04/2016
STATE OF ARKANSAS
PROFESSIONAL CONSULTANT SERVICES CONTRACT
CONTRACT #
FEDERAL I.D. #
YES 
NO 
VENDOR #
MINORITY VENDOR
1. PROCUREMENT:
Check ONE appropriate box below for the method of procurement for this contract:
 ABA Criteria
 Request for Proposal
 Competitive Bid
 Request for Qualifications
 Intergovernmental
 Emergency
 Invitation for Bid
 Cooperative Contract
 Small Order
 Sole Source by Justification
 Sole Source by Intent to Award
(Justification must be attached)
 Sole Source by Law - Act #
or Statute #:
 Exempt by Law
 Special Procurement
2. TERM DATES:
The term of this agreement shall begin on
and shall end on
.
(mm/dd/yyyy)
(mm/dd/yyyy)
3. CONTRACTING PARTIES:
State of Arkansas is hereinafter referred to as the agency and contractor is herein after referred to as the Vendor.
AGENCY NUMBER & NAME
Service Bureau
VENDOR NAME
VENDOR ADDRESS
TRACKING # 1
TRACKING # 2
4A. TOTAL PROJECTED CONTRACT COST:
Total Projected Cost of entire project if all available extensions of this contract are
$
completed (up to the date anticipated and stated in Section 13)
4B. CALCULATIONS OF COMPENSATION:
For work to be accomplished under this agreement, the Vendor agrees to provide the personnel at the rates
scheduled for each level of consulting personnel as listed herein. Calculations of compensation and reimbursable
expenses shall only be listed in this section. If additional space is required, a continuation sheet may be used as
an attachment.
LEVEL OF
NUMBER
COMPENSATION
TOTAL FOR
PERSONNEL
RATE
LEVEL
Total compensation exclusive of expense reimbursement
$
REIMBURSABLE EXPENSES
ESTIMATED
TOTAL
ITEM (Specify)
RATE OF REIMB.
Total reimbursable expenses
$
Total compensation inclusive of expense reimbursement
$
FORM PCS-1
Page 1 of 5
04/2016
STATE OF ARKANSAS
PROFESSIONAL CONSULTANT SERVICES CONTRACT
Contract # : _______________________
5.
SOURCE OF FUNDS:
Complete appropriate box(es) below to total 100% of the funding in this contract. You may use an attachment if
needed.
Fund
% of Total
Fund Source
Identify Source of Funds*
Fund
Amount of Funding
Center
Contract Cost
Other Funds
$
Other Funds
$
Other Funds
$
Other Funds
$
Other Funds
$
TOTALS
$
100%
* MUST BE SPECIFIC (i.e. fees, tuition, agricultural sales, bond proceeds, donations, etc.)
** “State Funds” is defined as and deemed State General Revenue Dollars. If other state funds are being used such as tobacco funds, general
improvement funds, etc., these should be noted. Special revenue funds from taxes or fees generated for the agencies should be shown as “Other”
and the actual source of the funds should be clarified in the “Identify Source of Funds.”
6.
RENDERING OF COMPENSATION:
The method(s) of rendering compensation and/or evaluation of satisfactory achievement toward
attainment of the agreement listed herein is as follows, or in attachment no. ______ to this agreement.
7.
OBJECTIVES AND SCOPE:
State description of services, objectives, and scope to be provided. (DO NOT USE “SEE ATTACHED”)
8.
PERFORMANCE STANDARDS:
List Performance standards for the term of the contract. (If necessary, use attachments)
FORM PCS-1
Page 2 of 5
04/2016
STATE OF ARKANSAS
PROFESSIONAL CONSULTANT SERVICES CONTRACT
Contract # : _______________________
9.
ATTACHMENTS:
List ALL attachments to this contract by attachment number:
10.
CERTIFICATION OF VENDOR
“I,
A.
(Vendor)
(Title)
certify under penalty of perjury that, to the best of my knowledge and belief, no regular full-time or part-
time employee of any State agency of the State of Arkansas will receive any personal, direct or indirect
monetary benefits which would be in violation of the law as a result of the execution of this contract.”
Where the Vendor is a widely-held public corporation, the term ‘direct or indirect monetary benefits’ “shall
not apply to any regular corporate dividends paid to a stockholder of said corporation who is also a State
employee and who owns less than ten percent (10%) of the total outstanding stock of the contracting
corporation.”
B.
List any other contracts or subcontracts you have with any other state government entities. (Not
applicable to contracts between Arkansas state agencies) (If no contracts or subcontracts, please put
“N/A” or “None”)
C.
Are you currently engaged in any legal controversies with any state agencies or represent any clients
engaged in any controversy with any Arkansas state agency? (If no controversies, please put “N/A” or
“None”)
D.
The Vendor agrees to list below, or on an attachment hereto, names, addresses, and relationship of
those persons who will be supplying services to the state agency at the time of the execution of the
contract. If the names are not known at the time of the execution of the contract, the Vendor shall
submit the names along with the other information as they become known. Such persons shall, for all
purposes, be employees or independent contractors operating under the control of the Vendor (sub-
contractors), and nothing herein shall be construed to create an employment relationship between the
agencies and the persons listed below.
NAME
RELATIONSHIP
E.
The agency shall exercise no managerial responsibilities over the Vendor or his employees. In carrying
out this contract, it is expressly agreed that there is no employment relationship between the contracting
parties.
FORM PCS-1
Page 3 of 5
04/2016
STATE OF ARKANSAS
PROFESSIONAL CONSULTANT SERVICES CONTRACT
Contract # : _______________________
11.
DISCLOSURE REQUIRED BY EXECUTIVE ORDER 98-04:
Any contract or amendment to a contract executed by an agency which exceeds $25,000 shall require the
Vendor to disclose information as required under the terms of Executive Order 98-04 and the Regulations
pursuant thereto. The Vendor shall also require the subcontractor to disclose the same information. The
Contract and Grant Disclosure and Certification Form (Form PCS-D attachment II-10.3) shall be used for this
purpose.
Contracts with another government entity such as a state agency, public education institution, federal
government entity, or body of a local government are exempt from disclosure requirements.
The failure of any person or entity to disclose as required under any term of Executive Order 98-04, or the
violation of any rule, regulation or policy promulgated by the Department of Finance and Administration
pursuant to this Order, shall be considered a material breach of the terms of the contract, lease, purchase
agreement, or grant and shall subject the party failing to disclose, or in violation, to all legal remedies
available to the Agency under the provisions of existing law.
12.
CANCELLATION CLAUSES
A. NON-APPROPRIATION CLAUSE PURSUANT TO §19-11-1012(11):
“In the event the State of Arkansas fails to appropriate funds or make monies available for any biennial period
covered by the term of this contract for the services to be provided by the Vendor, this contract shall be
terminated on the last day of the last biennial period for which funds were appropriated or monies made
available for such purposes.
“This provision shall not be construed to abridge any other right of termination the agency may have.”
B. CONVENIENCE CLAUSE:
In the event the State no longer needs the service or commodity specified in the contract or purchase order
due to program changes, changes in laws, rules, or regulations, relocation of offices, the State may cancel
the contract or purchase order by giving the vendor written notice of such cancellation 30 days prior to the
date of cancellation.
13.
TERMS:
The term of this agreement begins on the date in SECTION 2 and will end on the date in SECTION 2, and/or as
agreed to separately in writing by both parties.
This contract may be extended until
, in accordance with the terms stated
(mm/dd/yyyy)
in the Procurement, by written mutual agreement of both parties and subject to: approval of the Arkansas
Department of Finance and Administration/Director of Office of State Procurement, appropriation of
necessary funding, and review by any necessary state or federal authority.
Contracts will require review by Legislative Council or Joint Budget Committee prior to the approval of the
Department of Finance and Administration/Director of Office of State Procurement and before the execution
date if the total initial contract amount or the total projected amount is greater than or equal to $50,000,
including any amendments or possible extensions.
Any amendment which increases the dollar amount or involves major changes in the objectives and scope of
the contract will require review by Legislative Council or Joint Budget Committee.
14.
AUTHORITY:
A. This contract shall be governed by the Laws of the State of Arkansas as interpreted by the Attorney General of
the State of Arkansas and shall be in accordance with the intent of Arkansas Code Annotated §19-11-1001 et
seq.
B.
Any legislation that may be enacted subsequent to the date of this agreement, which may cause all or any
part of the agreement to be in conflict with the laws of the State of Arkansas, will be given proper
consideration if and when this contract is renewed or extended; the contract will be altered to comply with the
then applicable laws.
FORM PCS-1
Page 4 of 5
04/2016
STATE OF ARKANSAS
PROFESSIONAL CONSULTANT SERVICES CONTRACT
Contract # : _______________________
15.
AGENCY CONTACTS FOR QUESTION(S) REGARDING THIS CONTRACT:
Contact #1 – Agency Representative submitting/tracking this contract
(Name)
(Title)
(Telephone #)
(Email)
Contact #2 – Agency Representative with knowledge of this project (for general questions and responses)
(Name)
(Title)
(Telephone #)
(Email)
Contact #3 – Agency Representative Director or Critical Contact (for time sensitive questions and responses)
(Name)
(Title)
(Telephone #)
(Email)
16.
AGENCY SIGNATURE CERTIFIES NO OBLIGATIONS WILL BE INCURRED BY A STATE AGENCY
UNLESS SUFFICIENT FUNDS ARE AVAILABLE TO PAY THE OBLIGATIONS WHEN THEY BECOME DUE.
17.
SIGNATURES:
VENDOR
DATE
AGENCY DIRECTOR
DATE
TITLE
TITLE
ADDRESS
ADDRESS
APPROVED:
DEPARTMENT OF FINANCE AND ADMINISTRATION
DATE
FORM PCS-1
Page 5 of 5
04/2016
Arkansas Tax Forms Arkansas Department of Finance & Administration Arkansas Legal Forms United States Tax Forms Financial United States Legal Forms

Popular Articles

Most popular documents

Featured Tags

Bill of Sale U.S. Department of Veterans Affairs United States Army Vehicle Bill of Sale U.S. Department of Defense Boat Bill of Sale Firearm Bill of Sale Generic Bill of Sale Cover Letter Template Resume Templates U.S. Department of the Treasury - Internal Revenue Service BMI Chart Resignation Letter Template Multiplication Chart Graph Paper
Form PCS-1 Printable Pdf
Download pdf Fill PDF online

Related forms

Most popular documents

Related Documents

Popular Articles

Page of 5