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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: Care Fusion Party/Vendor Contact Person: Christopher Legault Contact Phone: 888.876.4287 Party/Vendor <br /> Address: 22745 Savi Ranch Parkway City Yorba Linda State:CA Zip:92887 Department: Public Health Amount: $1,5 10.00 Purpose: <br /> Provider shall contract its services by providing the OCHD with it's products Budget Code(s): 10412020-680007 Vendor#N/A (N/A if <br /> new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type:(Check one)New® Renewal❑ Amendment ❑ <br /> Effective Date April 16,2014 Approved by Board Yes❑No❑ Agenda Date: Title of Contract: CareFusion <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: �t.�- 4 Date: <br /> (Applicable on y urchases or e related services)This contract has been reviewed and approved by t Information <br /> Technology Director as to technical content and in orma ion <br /> IT Qjrert�r'g Signature <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 provisions as sho ��' pFP <br /> by the Risk Manager: <br /> Risk Manager's Signature: Date: I MAY 1 3 2614 <br /> Financial Services 4#01 <br /> This Contract is conditioned u n appropriation by the Board of Commissioners Yes❑NoEV A bud <br /> before approval Yes❑No[9. f 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 ct: <br /> Financial Services Director's Signature: Date: "P t <br /> 511% <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). Approval by Manager[(Most other contracts$1,000 and above). Department Director approval only❑ (Under <br /> $1,000). This contract has be reviewed and approved by the Attorney as to legal form and sufficiency: ,,{{ <br /> Attorney's Signature Date: (T� <br /> County Manazer <br /> This contract has been reviewed and i a rov by the County Manager Yes To❑. <br /> This contract has been reviewed an is f s' tur he air es❑No❑. <br /> C/ <br /> Manager's Signature: Date. <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 />