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ORANGE COUNTY—CONTRACT CONTROL SHEET <br /> Routing Order: (1)Department,(2)IT,(3)Risk Management,(4)Financial Services,(5)Attorney,(6)Manager,(7)Clerk <br /> This Document shall accompany all contracts and shall be submitted for signature in the Routing Order specified above. If the Manager <br /> determines the contract is not appropriate for Manager approval the Manager shall submit the contract for BOCC approval. Contracts for <br /> BOCC approval must be submitted through,and complete,the routing process prior to agenda review. Contracts for legal review should <br /> be completed through the legal review process prior to being routed for signature. <br /> Department <br /> Party/Vendor Name: WASTE MANAGEMENT HEALTHCARE SOLUTIONS Party/Vendor Contact Person: BRIAN BUERKETT <br /> Contact Phone: 713 265 1287 Party/Vendor Address: 1001 FANNIN City HOUSTON State:TX Zip: 77002 Department:HEALTH <br /> Amount: $1,560 ANN-UAL Purpose:DISPOSAL OF MEDICAL WASTE Budget Code(s): 10414020-622100 Vendor#N/A (N/A if <br /> new vendor) Vendor is a BOCC consultant? Yes❑NoN Contract Type:(Check one)New[D Renewal <br /> ❑ Amendment ❑ <br /> Effective Date 4/1/13 Approved by Board Yes❑No❑ Agenda Date: Title of Contract: CUSTOMER SERVICE <br /> AGREEMENT WASTE MANAGEMENT <br /> If this is a Grant Agreement,pre-application has been approved by the Board of Commissioners Yes❑No❑. If submitted for bid were <br /> bids/RFPs received Yes❑No❑ Bid/RFP number This contract has been reviewed and approved by the Department Director as to <br /> technical content: <br /> Department Director's Signature: ki,L- Date: j 13 <br /> IT Director <br /> Ira t has b reviewed(Applicable only to hardware e urchases or related steer contract has been reviewed and approved by the Information <br /> only t ry <br /> v <br /> 10 if i <br /> Technology Director as to technical content ion technology specifications: <br /> IT Director's Signature: Datt <br /> e: <br /> Risk Management <br /> Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Require [Hold <br /> Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as shown,this contract is approved <br /> by the Risk Manager: <br /> Risk Manager's Signature: Au_ Date: 3 /j <br /> 5 1 Z-71 I 3 <br /> Financial Services <br /> This Contract is conditioned upon appropriation by the Board of Commissioners Yes❑No� A budget amendment is necessary <br /> before approval Yes❑Nog If budget amendment is necessary,please attach to this form. This instrument has been pre-audited in the <br /> manner required by the Local Government Bupde and Fiscal Contr I Act: <br /> Financial Services Director's Signatu-e. 3, /)"U, Date: <br /> County Attorney <br /> Approval by Board ❑ (Contracts $90,000.00 or more for goods or services, $250,000.00 or more for construction, or any BOCC <br /> consultant contract). Approva y Manager[(Most other contracts$1,000 and above). Department Director approval only❑(Under <br /> $1,000). This contract:has be iewe d proved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature tr - Date: 1:�,, <br /> V \, <br /> County Manage <br /> This contract has been reviewed and is approved by the County Manager <br /> This contract has been reviewed and is for signature by tKe Qhair YesF1NeEj--- <br /> '2 <br /> Manager's Signature: Date/- <br /> V — I/ 7-:) <br /> Clerk to the Board <br /> Approved by BOCC on the_day of 20 Submitted for Chair signature on the day of 20 <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />