HomeMy WebLinkAboutR 2015-682 ES - Orange CTY Emergency Medical SC-1155 v 2ORANGE COUNTY—DEPARTMENT USE ONLY
______________________________________________________________________________
Department
Party/Vendor Name: Physio-Control, Inc. Party/Vendor Contact Person: Alexandra Carvalho Contact Phone: 800-
442-1142 x 74003 Party/Vendor Address: 11811 Willows Rd. NE City Redmon State: Washington Zip: 98052
Department: Emergency Services Amount: $30,315.00 Purpose: Physio Control Life Pak 15 service and
maintenance Budget Code(s): 10757520571000 Vendor # 45414 (N/A if new vendor) Vendor is a BOCC
consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective Date July
1, 2015 Approved by Board Yes No Agenda Date:
This agreement is approved as to technical form and content:
Department Director’s Signature ________________________________________ Date: ________
Information Technologies
(Applicable only to hardware/software purchases or related services) This agreement has been reviewed and is
approved as to information technology content and specifications:
Office of the Chief Information Officer___________________________________ Date: ________
Risk Management
This agreement is approved for sufficiency of insurance standards, specifications, and requirements:
Office of the Risk Management Officer___________________________________ Date: _________
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act:
Office of the Chief Financial Officer ____________________________________ Date: _________
Legal Services
This agreement is approved as to legal form and sufficiency:
Office of the County Attorney __________________________________________Date: ________
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@orangecountync.gov
The following signature block is for hard copies only and is not required for Docusign contracts:
DocuSign Envelope ID: C12F223A-4347-43A3-A8B5-16DEB750E333