HomeMy WebLinkAboutR 2014-228 Health - Care Fusion - provide OCHD with it's products 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: Care Fusion Party/Vendor Contact Person: Christopher Legault Contact Phone: 888.876.4287 Party/Vendor
Address: 22745 Savi Ranch Parkway City Yorba Linda State:CA Zip:92887 Department: Public Health Amount: $1,5 10.00 Purpose:
Provider shall contract its services by providing the OCHD with it's products Budget Code(s): 10412020-680007 Vendor#N/A (N/A if
new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type:(Check one)New® Renewal❑ Amendment ❑
Effective Date April 16,2014 Approved by Board Yes❑No❑ Agenda Date: Title of Contract: CareFusion
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: �t.�- 4 Date:
(Applicable on y urchases or e related services)This contract has been reviewed and approved by t Information
Technology Director as to technical content and in orma ion
IT Qjrert�r'g Signature
Risk Management
Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required ❑. Hold
Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as sho ��' pFP
by the Risk Manager:
Risk Manager's Signature: Date: I MAY 1 3 2614
Financial Services 4#01
This Contract is conditioned u n appropriation by the Board of Commissioners Yes❑NoEV A bud
before approval Yes❑No[9. f 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 ct:
Financial Services Director's Signature: Date: "P t
511%
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). Approval by Manager[(Most other contracts$1,000 and above). Department Director approval only❑ (Under
$1,000). This contract has be reviewed and approved by the Attorney as to legal form and sufficiency: ,,{{
Attorney's Signature Date: (T�
County Manazer
This contract has been reviewed and i a rov by the County Manager Yes To❑.
This contract has been reviewed an is f s' tur he air es❑No❑.
C/
Manager's Signature: Date.
Clerk to the Board
Approved by BOCC on the_day of ,20 . Submitted for Chair signature on the_day of ,20
Clerk's Signature: Date:
Revised March 2012