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� i 1 <br /> 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: PHYSIO-CONTROL. I_NC. Party/Vendor Contact Person: Lane Rushing Contact Phone: 18004421142(eat <br /> 72368) Party/Vendor Address: 1 181 1 Willows Rd.NE PO BOX 97006 City Redmond State:WA Zip:98052 Department:Emergency <br /> Services Amount: 16,083.00 Purpose:Defibrillator Service and Maitenancc Budget Code(s):_10757520-630000 Vendor#45414 (N/A <br /> if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type:(Check one)New❑ Renewal® Amendment ❑ <br /> Effective Date July 1,2013 Approved by Board Yes❑No® Agenda Date: _ Title of Contract:Physio-Control Technical <br /> Service Support Agreement A60-3184 <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/REP u�t ec Thi ontract has been reviewed and approved by the Department Director as to <br /> technical content: J <br /> Department Director's Signature: Date: -- <br /> t � IT Director <br /> (Applicable only to hardii arelsoftwcrre purchases at-related services)This contract has been reviewed and approved by the Information <br /> Technology Director as to technical content and information technology specifications: <br /> IT Director's Signature: Date: <br /> Risk Management <br /> Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required ❑. Hold <br /> Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provision�n,this contract is approved <br /> by the Risk Manager: e-�.r (y" � <br /> Risk Manager's Signature: Date: /Q <br /> Financial Services <br /> This Contract is conditioned Won appropriation by the Board of Commissioners Yes❑No[� A budget amendment is necessary <br /> before approval Yes❑No❑. 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 Budget and Fiscal Control Act: <br /> Financial Services Director's Signature:_ x ' ' Date: t <br /> VIA I <br /> County Attorney <br /> Approval by Board ❑ (Contracts $90,00 0 or more for goods or services, $250,000.00 or more for construction, or any BOCC <br /> consultant contract). Approval Ma iager�(Most other contracts$1,000 and above). Department Director approval only❑(Under <br /> $1,000). This contract has bee r� ie d l approved by the Attorney as to legal form and sufficiency: <br /> ` <br /> Attorney's Signature Date: <br /> 4 <br /> County Manager <br /> This contract has been reviewed an/I ap ove y the County Manager Yes6'N 0. <br /> This contract has been reviewed n is to ig at ire e it ❑No❑. <br /> Manager's Signature: Date: <br /> Clerk to the Board <br /> Approved by BOCC on the day of 120 Submitted for Chair signature on the day of 20 <br /> Clerk's Signature: Date:_ <br /> ReVi9ea t"i2.'_'�_"ch 2012 <br />