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..2c�1�•-537 <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 Party/Vendor Contact Person: Lane Rushine Contact Phone:425-867-2368 Party/Vendor <br /> Address: 11811 Willows Road NE City Redmond State: WA Zip: 98052 Department: Orange County Emergency Services Amount: <br /> $16,688.00 Purpose:Technical Support Agreement Budget Code(s): 10757520-571000 Vendor#45414 (N/A if new vendor) Vendor <br /> is a BOCC consultant? Yes❑No❑ Contract Type:(Check one)New❑ Renewal❑ Amendment ❑ Effective Date <br /> Approved by Board Yes❑No❑ Agenda Date: Title of Contract: <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 T • contract has been reviewed and approved by the Department Director as to <br /> technical content: !J <br /> Department Director's Signature: Date: �� 7 <br /> IT Director <br /> (Applicable only to hardware/software purchases or 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 provisions as sho , <br /> by the Risk Manager: D <br /> Risk Manager's Signature: u Date- l OCT 16 2014 <br /> Financial Services <br /> This Contract is conditioned ypon appropriation by the Board of Commissioners Yes❑No[2/ A bu B <br /> before approval Yes❑NoLY. 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: a"--< , Date: 10 l'7 <br /> County Attornev <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 anagerk(Most other contracts$1,000 and above). Department Director approval only❑ (Under <br /> $1,000). This contract has bee r wed and approved by the Attorney as to legal form and sufficiency Q_ <br /> Attorney's Signature Date: lO 1_1 1 1 <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Yes �NoFEJI. <br /> This contract has been reviewed and is for si ature by the Chair Yes❑No❑. <br /> Manager's Signature: Date: a A3 <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 />