HomeMy WebLinkAbout2012-353 S Health - ALSCO for Textile Rental Services $1,300 ORANGE COUNTY-CONTRACT CONTROL SHEET
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: ALSCO Party/Vendor Contact Person: Contact Phone:— Party/Vendor Address: City
State:— Zip:_ Department: Health Amount:41,300 Purpose:Textile Rental Service Agreement Budget Code(s):
Vendor#— (N/A if new vendor) Vendor is a BOCC consultant? Yes❑NoZ Contract Type:(Check one)New❑ Renewal
❑ Amendment ❑ Effective Date. Approved by Board Yes❑NoZ Agenda Date: — Title of Contract:
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:
Department Director's Signature: Date:
IT Director
(Applicable only to hardwarelsoftware purchases or related services)This contract has been reviewed and approved by the Information
Technology Director as to technical content and information technology specifications:
IT Director's Signature: Date:
Risk Manazement
Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OF. No Insurance Required F.' Hold
Contract pending receipt of Certificate of Insurance M. With incorporation of Insurance provisions as shown,this contract is approved
by the Risk Manager: 1
Risk Manager's Signature: Date:A
a I Z.-I
This Contract is conditioned Financial Services
on appropriation by the Board of Commissioners YesE]No A budget amendment is necessary
before approval Yes❑No[y. If budget amendment is necessary,please attach to this form. This iiistrument has been pre-audited in the
manner required by the Local Government Budget and Fiscal Control Act:
Financial Services Director's Signature: "a /� Date:
County Attorney
Approval by Board ❑ (Contracts $90,000.00 or more for goods or services, $250,000.00 or more for construction, or any BOCC
consultant contract).c=oyby Mart"r❑ (most other contracts$1,000 and above). Department Director approval only (Under
$1,000). This contra b view d approved by the Attorney as to legal form and sufficiency:
Attorney's Signature Date:-9-
County Manage
This contract has been reviewed and is approve 0y the County rmaiiager YesPIW471.
This contract has been reviewed and is for sign Ch it sEjNo07
Manager's Signature: 7xrr) Date:
erk to the Board
—
Approved by BOCC on the_day of 0 Submitted for Chair signature on the_day of_,20_.
Clerk's Signature: Date:
Revised March 2012