HomeMy WebLinkAbout2012-059 S Housing - Telelanguage $ As neededRANGE COUNTY - CONTRACT CONTROL SHEET l
Routing Order: (1) Department, (2) IT, (3) Risk Management, (4) Financial Services, (5) Attorney, (6) Manager, (7) Clerk
This Document shall accompany all contracts and shall be submitted for signature in the Routing Order specified above. If the Manager
determines the contract is not appropriate for Manager approval the Manager shall submit the contract for BOCC approval. Contracts for
BOCC approval must be submitted through, and complete, the routing process prior to agenda review. Contracts for legal review should
be completed through the legal review process prior to being routed for signature.
Department
Party/Vendor Name: Telelaneuage Party/Vendor Contact Person: Jeri Nimon -Toki Contact Phone: 503 -535 -2178 Party/Vendor
Address: 421 SW 6th Ave. Suite 1150 City Portland State: OR Zip: 97204 Department: Housing/Human Rights and Community
Development Amount: $As Needed Purpose: Interpretation Services Budget Code(s): 3 4 6'06790008 71300 - Vendor # N/A (N /A if
new ven or Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ Amendment ❑
Effective Date March 1; 2012 Approved by Board Yes❑ No® Agenda Date: Title of Contract: Telelanguage Service
Agreement
If this is a Grant Agreement, pre - application has been approved by the Board of Commissioners Yes❑ No ®. If submitted for bid were
bids/RFPs received Yes❑ No❑ Bid/RFP number This contract has been reviewed and approved by the Department Director as to
technical content: o�(
Department Director's Signatu e: Date: �p2
IT ' ctor
(Applicable only to hardware /software purchases or related servi s) ntract has been reviewed and approved by the Information
Technology Director as to technical content and information technology specifications:
IT Director's Signature:
Date:
Risk Management
Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; Q'OR No Insurance Required ❑. Hold
Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as shown, this contract is approved
by the Risk Manager:
Risk Manager's Signature: F Ali.. Date:
rC/ 20
Financial Services
This Contract is condition upon appropriation by the Board of Commissioners Yes ❑Nox. A budget amendment is necessary
before approval Yes❑ No . If budget amendment is necessary, please attach to this form. This instrument has been pre- audited in the
manner required by the Local Government Budget and Fiscal Control Act:
Financial Services Director's Signature: y ��" �� Date: 3 2— 2
Countv Attorne
Approval by Board ❑ (Contrpls over $90,000.00 for goods or services, $250,000.00 for construction, or any BOCC consultant
contract). Approval by Manag r (All o contracts). This contract has been reviewed and approved by the Attorney as to legal
form and sufficiency:
Attorney's Signature Date:
County Manager
This contract has been reviewed and is approved by the County Manager Yes o❑
This contract has been reviewed and is to be submitted fo BOCC conside a ion Yes❑NO�'
�Z._
Manager's Signature: Date:
Clerk to the BaUd
Approved by BOCC on the _ day of , 20 Submitt d for s ` si a on a 'day of , 20
Clerk's Signature: Date:
Revised April 2010