HomeMy WebLinkAboutR 2019-744 Emergency Svc - Excellance contract amendment DocuSign Envelope ID:791B8A8D-56E7-46E8-9C1E-E15DF599B542
ORANGE COUNTY---DEPARTMENT USE ONLY---HARD COPY ONLY
Department
Party/Vendor Name: Excellance, INC. Party/Vendor Contact Person: Tommy Pugh Contact Phone: (256) 772-9321
Party/Vendor Address: 453 Lanier Rd. City Madison State: Al Zip: 35758 Department: Emergency Services Amount:
$247,193.20 Purpose: Ambulance Remount (Amend #840-2252 to #843-2310) Budget Code(s): 61757535-8020000-30010
Vendor#59564 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one)New ❑
Renewal ❑ Amendment ® Effective Date Approved by Board Yes® No❑ Agenda Date: FY18-19 BOCC
01/22/2019
This agreement is approved as to technical form Docusigned by:
�t� y�tr5 10/9/2019
Department Director's Signature 5655BC89IA64473. 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 insurr----D-oc-uSi9n-ea ar-----=ications,and requirements:
1US66 (AVln. 6 10/10/2019
Office of Risk Management Date:
7FDCF9176800498.
Financial Services
This instrument has been pre-audited in the manner re . Docusigned by: - mment Budget and Fiscal Control Act:
Office of the Chief Financial Officer 4 Date: 10/11/2019
7D4E51S1ACC1409.
Legal Services
This agreement is approved as to legal form and suff ' Docusigned by:
Office of the County Attorney �•�'°' - Date: 10/11/2019
4035CB8304CA4M
Clerk to the Board
Received for record retention:
Office of the Clerk to the Board Date:
Revised December 2016