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HomeMy WebLinkAbout97- Disaster and Emergency Services coordinator and Hazardous Materials Contract ..--.... -- DISASTER AND EMERGENCY SERVICES COORDINATOR AND HAZARDOUS MATERIALS CONTRACT , THIS AGREEMENT is made and entered into this 1 st day of July, '1997, by and betWeen Gallatin County, Montana, a political subdivision of the State of Montana, hereinafter referred to as "County" and the City of Bozeman, Montana, hereinafter referred to as "Contractor", WITNESSETH: WHEREAS, Title 1 0, Chapter 3, Parts 1 through 4 MCA provide counties with the authority and responsibility to provide disaster and emergency services; and, WHEREAS, Title 7, Section 33, Part 220'1, et seq., MCA authorizes the County to protect range, farm, and forest resources from fire and to appoint a county rural fire chief; and, WHEREAS, the County has a need for professional response to hazardous material incidents by the Contractor who has technical expertise and equipment; and, WHEREAS, the Contractor through the Bozeman Fire Chief and staff are trained in disaster emergency response, and have equipment necessary to respond to natural and manmade disaster; and, WHEREAS, the Contractor through the Bozeman Fire Chief has the technical expertise and equipment necessary to respond to hazardous material emergencies; and, WH!::REAS, the County and the Contractor desire to enter into one agreement for disaster and emergency services, and hazardous material response and training so as to provide consistent information and coverage to all residents of Gallatin County. NOW THEREFORE, it is agreed by and between the County and the Contractor as follows: 1 E.ldIPQS_~: The purpose of this agreement is to provide and secure the centralizing of disaster and emergency services and hazardous materials response in one cohesive organization for the benefit of all residents in Gallatin County, Term: This agreement shall become effective on July 1, 1997, and shall remain in effect through June 30, 1998, unless terminated as provided in Section 10 This agreement shall automatically renew, unless either party sends written notice of termination on or before April 1, of subsequent years, Notice shall be sent to the addresses contained herein 2, Levels of Qe.Q(Jc.~,:, The Contractor shall have the following duties and responsibilities: a) Disaster and Emergency Services: i) Maintain a realistic county-wide Emergency Operations Plan (EOP); - - - - --.---.-- ..-. --- , ) ~ ii) Provide yearly exercises of the EOP and Emergency Operations Center (EOC); iii) Store Radiological instruments and be trained in their use; iv) Prepare critique of emergencies and disasters within the county; v) Identify shortcomings in the local communities' response capabilities, and facilitate solutions; vi) Provide training opportunities to county commiSSIoners, managers general public and responders for all risk emergencies: vii) During emergencies and disasters, staff the Emergency Operations Center and establish procedures for effective response; viii) Coordinate with the private sector, including but not limited to: Gallatin Airport, Bozeman Deaconess Hospital, the Ham Radio Operators Association, the American Red Cross, and the Search and Rescue Volunteers. The contractor shall coordinate with public sector entities, including but not limited to: Department of State Lands, the United States Forest Service, the Gallatin County Sheriff's Department, and Montana State University; ix) Assist and advise Gallatin County on compliance with the requirements of Title 10 Chapter 3, Parts 1 through 4 MCA: x) AssIst and advise Gallatin County on compliance with the requirements of SARA subtitle III (TO BE CLARIFIED) xi) Participate in the annual Governor's Conference on Disaster and Emergency Preparedness, and continue with ongoing training as may be required of Disaster and Emergency Coordinators by the State of Montana: xii) Report to the County Commission on a quarterly basis stating the activities undertaken and the steps taken to comply with the provisions of this contract; xiii) Prepare a yearly budgetary request covering supplies, equipment, contractual costs, training and capital expenses, b) Haz Mat Services: i) Provide effective coordinated emergency response support to local jurisdictions for incidents involving the release or potential release of hazardous materials at transportation and fixed site spills; releases or threat of release of hazardous materials and incidents involving abandoned materials which may pose a threat to human health or the environment; ii) Provide remote or on-site technical assistance and advice to local jurisdiction incident commander when requested; iii) To control the actual release or threatened release of hazardous materials for the purpose of control or stabilization of the incident for local jurisdictions at the request and under the direction of the incident commander; iv) To respond to releases or threatened releases of hazaraous materials for the purpose of control or stabilization of the incident for local jurisdictions at the request and under the direction of the incident commander; v) To implement and use the Incident Management System (1M3) on all support responses for team operations; 2 .'. ~',. vi) Cooperate with the directions of the local jurisdiction incident commander for on-site emergency response activities; vii) Educate and train employees in hazardous materials response on a continuing basis, as required by O.S,H.A. and E.P..A, regulations; viii) Participate in incident critique to aid in future prevention and improved emergency response; ix) Designate fire department personnel to an emergency response duty roster; x) Develop and implement local standard operating procedures for hazardous materials emergency response; and, xi) Maintain a regional hazardous materials response team for support of hazardous materials operations by regional jurisdictions in accordance with the Montana Hazardous Materials and Incident Management and Response Support Plan 3. QJJties Of County: The County shall have the following duties, in addition to the finance costs stated in Section 5 'Compensation': a) Provide and maintain an Emergency Operations Center (EOC) equipped with phone lines, office supplies and equipment mutually agreed upon between the Contractor and the County; b) Participate in a minimum of one (1) emergency response exercise per year; c) Assist with resources and personnel as needej for an emergency response; d) Respond to calls to the EOC when requested by the Contractor during an Emergency Response; e) Pay for the registration and travel costs of one employee of the contractor for the annual Governor's Conference on D.E,S, Preparedness, and for any other training required by the State of Montana for Disastw and Emergency Coordinators; f) Maintain an operations budget covering the costs and anticipated costs of rendering DES services, pursuant to the items stated in this agreement; 4. Compensation The Contractor will be compensated in an amount mutually agreed upon before May 31, of each year, The FY 98 mutually agreed upon amount is $43,621 for D,E.S activities, The parties agree that in the event of significant extenuating circumstances requiring the utilization of personnel and equipment for activities not anticipated during the negotiations on this contract, the Contractor may be entitled to additional compensation beyond the agreed upon amount of this agreement. Any additional compensation must be mutually agreed upon, The Contractor must notify the County prior to or as soon as possible when additional compensation is anticipated. Payments shall be made in four (4) quarterly installments, The County shall make remittance on or before Sept. 1, Dec, 1, March 1, and June 1 of each year, 1i. J:;LQ.?-_<3rdous Material Budget Allocation: The County and the Contractor shall meet during the first week of May each year that this agreement is in effect to 3 ~- '-. -'... establish a joint budget for Hazardous Materials Expenses, A detailed request will be prepared by the Bozeman Fire Chief prior to the joint meeting, At the joint meeting detailed spending authority will be negotiated. The funding for the Hazardous Materials budget shall be split equally between the County and the City of Bozeman, Other incorporated areas and MSU will be approached and contracted with for funding of the Haz Mat Response, (i. Liability and Insura,nce: a. .lnsuranc~..,; The Contractm shall provide the following Insurance coverage and proof of coverage to the County by delivering a certificate of insurance or other proof of insurance to the Gallatin County Commissioners, Gallatin County Courthouse, 311 West Main Street, Room 301, Bozeman, MT 59715, within ten (10) days of execution of this agreement. I. Workers' Compensation, Contractor shall provide Workers' Compensation for all employees hired to accompiish the duties dessribed in this agreement. II. ~omplehensive General Liability Insurance, Contractor shall carry comprehensive general liability insurance which includes bodily injury and property damage, with limits of not less than the statutory limits which are currently established at $750,000 for each claim and $1,500,000 for each occurrence, b LiabiJl1y: Contractor shall hold harmless and indemnify the County, its officers, employees, and agents against any and all actions, suits, claims, demands, or liability of any character whatsoever, brought or asserted for injuries to or death of any person or persons, or damage to property arising out of, resulting from, or occurring in connection with this contract, but only in proportion to and to the extent such liability, loss, expense, attorneys' fees, or claims for injuries or damages are caused by or result from the negligent or Intentional acts or omissions of the Contractor, its officers, agents, or employees, 7 C~gQjJqJ pur~hases: Purchases of equipment, apparatus and protective clothing for Hazardous Material shall be jointly owned, based on the amount the city and county contributed to their purchase, In the event this contract is not renewed capital purchases will be divided based upon the proportionate contribution made for these assets. Remaining consumable supplies will be divided equally between the parties~ 8. JermLml1ion: This agreement may be terminated upon mutual agreement of the parties, upon failure of the Contractor or County to perform its duties as specified in this agreement, or by either party given thirty (30) day written notice to the other party. In the event that termination under this paragraph occurs prior to the expiration of the term of this agreement the Contractor shall refund unexpended funds. 9, Compliance. If the funds are paid to the Contractor under this agreement and the Contractor is unable to provide the services or facilities as specified in this agreement, the funds must be returned to the County. Any unexpended funds at the end of each year shall be remitted to the county. 4 ~~--'-, 10. Records. The Contractor shall maintain accounts, records and other evidence pertaining to the funds expended under this agreement for a period of five (5) years. The system of accounting employed by the Contractor shall be in accordance with generally accepted accounting principles and wi!! be applied in a consistent manner so that the expenditures under this agreement can be clearly identified from all other expenses, 11, Ind;mendent Provider/Agency. The Contractor is an independent provider or contractor, providing services or facilities for the County, Neither the Contractor nor any of its employees are employees of the County under this agreement, nor wili they be considered employees of the County under any subsequent amendment to this agreement, unless otherwise expressec To that end, the County will not be responsible for withholding of any state and federal taxes or social security, nor will the County extend any of the benefits to the Contractor that it extends to employees of the County, The Contractor will be required to maintain the necessary workers' compensation coverage for its employees, unless mutually agreed to between the parties to this agreement 12, Interpretation This agreement shall be governed and interpreted according to the laws of the State of Montana. a) The section headings contained herein are for convenience only and are not intended to define or limit the scope of any provisions of this agreement. b) The provisions of this agreement are independent and severable. and the invalidity, partial invalidity, or unenforceability of anyone provision or portion thereof shall not affect the validity or enforceability of any other provIsion. 13. ~ntin:L6greement. This agreement is the entire agreement between the parties, No alterations, modifications, or additions to this agreemen~ shalf be binding unless reduced to writing and signed by the parties 14 AVgjJQ.QU jty_Qf..E u rills. The County and Contractor agree that if, for any reason, revenues received by the county are insufficient to pay the amount agreed to that the County may adjust the amount specified based on actual availability of cash and revenue, In the event that funds are decreased the parties agree to negotiate the level of services proportionate to any reduction in funding. 15, Amendment Yo Agreement Amendments to this agreement may be made jointly by the parties. All amendments must be in writing and signed by both parties prior to implementation. 16 An IJ!J.P I IDY_e..oto[y Qf 8~s.~lli 6nc;;t Assigned Values. On or before June 15 of each year the contractor shall submit a list of fixed assets and assign a value to each item_ 17, Bjiliog AnQ CoJle_clion For Recovera_pls; c.L!OQ9.. The Contractor is responsible for the submitting of the report to the State of Montana for reimbursement of DES funds. The Contractor is also responsible to prepare bills and submit them to the 5 L........-. ............ , appropriate third party for recovery of expenses associated with hazardous materials and disaster services. DP,TED this 13th day of June, 1997, GALLATIN COUNTY CITY 8F BOZEMAN BOARD OF COUNTY COMMISSIONERS r C? ~ /7/// (f..:.~~. er Phil Olson, Chairman ATIEST v .L~U.-4~0 G!J.:J ~ mber /, Robin Sullivan, City Clerk A TIEST: /'7 APp;;?aS t7 f~IJl1:. \ ~//(flt;IL(Y.{' vJ - PaGI-Luwe! /'/ L City Attorn~ ,- winword\des\97des, con 6 . -- ': ! MODIFICATION TO AGREEMENT DISASTER AND EMERGENCY SERVICES COORDINATOR AND HAZARDOUS MATERIbLS THIS MODIFICJ.I~TION TO AN AGR.EEMENT, is made by and between: GALLATIN COUNTY, 31.1 W. Main StY'eet, Room 301, Bozeman, Montana 59715, Telephone: 406-582-3000 ("COUNTY"); ane., CITY OF BOZEMAN, 411 E. Main, Bozeman, Montana 59715, Telephone: 406-582 2 3 0 0 (" CITY") . WHER.EAS, the COUNTY and CITY entered into Gallatin County- Contract 98-62 on June 13, 1997 which went into effect on July 1, 1997 regarding Disaster and Emergency Services Coordinator and Hazardous Materials ("Agreement") i and, WHEREAS I the pa:::ties intend to modify typographical inconsistencies in the .i\greement and augment compensation for Fiscal Year 1999; NOW, THEREFORE, lD consideratioD of the terms, conditione, covenants and performance contained herein the Parties here La agree to modify the Agreement as follows: 1. Page 2, Section 2.a.x of the Agreement shall be modified as follows: Assist and advise Gallatin County on compliance with the requirements of SARA Subtitle III. 2. Page 3, Section 4 of the Agreement shall be modified as follows: Compensation: The Contractor will be compensated in an amount mutually agreed upon before May 31 of each year, The FY 99 mutually agreed upon amount is $45,754 for DES activities. END OF AGREEMENT EXCEPT FOR SIGNATURE PAGE III I" ~, DATED this dIf day of July, 1998. GALLATIN COUNTY CITY OF BOZEMAN COMMISSIONERS ~\ \ w ~_ _m,"",_ Clark Johnson, eny Manager Phil Olson. Chaim1an ATrEST: f2L /~~ A!o-Il1d~/;rC.- ,(~'c;)7af~ Robin Sullivan, Citv Clerk Jarvis Brown. Member J APPROVED--A:S TO FORM: ATTEST: - ::#~ ,12 - aul D~~~~y ----- -- ,- (~~~'d~r J/ .,/ . ,. SECOND MODIFICATION TO AGREEMENT DISASTER AND EMERGENCY SERVICES COORDINATOR AND HAZARDOUS MATERIALS TIllS MODIFICATION TO AN AGREENfENT, is made by and between: GALLATIN COUNTY, 311 W. Main Street, Room 301, Bozeman, Montana 59715, Telephone: 406-582-3000 ("COUNTY"); and, CITY OF BOZElVIAN, 411 E. Main, Bozeman, Montana 59715, Telephone: 406-582-2300 ("CITY"). WHERE.A.s, the COUNTY and CITY entered into Gallatin County Contract 98-62 on June 13, 1997 which went into effect on July 1, 1997 regarding Disaster and Emergency Services Coordinator and Hazardous Materials ("Agreement"); and, WHEREAS, the County and City amended the Agreement by written modification dated July 28, 1998; WHEREAS, the parties intend to modity the Agreement to augment compensation for Fiscal Year 2000; NOW, THEREFORE, in consideration of the terms, conditions, covenants and pertorrnance c8ntained heniin the Parties hereto agree to modify the Agreement as tallows: l. All terms of the Agreement and the modification referenced herein arc incorporated by reference herein except the following changes shall be made: A The first paragraph of Page 3, Section 4 of the Agreement shall now read: Compensation: The Contrac1:or will be compensated in an amount mutually agreed upon before May 31 of each year. The FY 00 mutually agreed upon amount is $47,171.40 for DES activities. END OF AGREE\1ENT EXCEPT FOR SIGNATURE PAGE . ' '-' . r- (, DATED this day of JtJ!trnlwv:1999. I GALLATIN COUNTY CITY OF BOZEMAN COMMISSIONERS -- -~- \ \ - Clark Johnson, City Manager ATTEST: ~ ol~;,--" --- Robin Sullivan, City Clerk Jennifer Smith Mitchell, Member ATTEST: ~56 p)Jr?( / (~/f/1 r!--L Shelley Vance, C(erk & Recorder - County Commission GALLATIN COUNTY William A. Murdock Phil Olson Jennifer Smith Mitchell 311 West Main, RIll. 301 · Bozeman, MT 59715 Phone (406) 582-3000 FAX (406) 582-3003 M E 1\1 0 R A N D U 1\;1 ----,--~~~---~~-~~~------~~-~--_._-- DATE: J 1 '-'0 -r 99') " u y " , ." TO: Aaron Ilolst, DES COGrdinatot' ~ ~ wW\ FROM: COLlnty Conunissioners RE: Disaster & Elner:~ency Services Cocll'dinator & HazarclousMatcrials A;;reement _"_,_,,,._~_.~_~ ~m.,"'.w,. 'lUll are hereby notified that Gallatin County wishes to maintain its current status with the City of Bozeman with n_\~~ard to the delivery of DES & HaZlvlat services, inclusive of the second Jllodification to Contract I ~)~).s-G2. It' YOLI need anydring fLlrther, please contact us. r:\ winword \des\ h "!,It. doc . . COUNTY CONTRACT ROUTING FORM GALLATI~ COUNT: CONTRACT ~~ 2 flfi-"~ NAME OF CONTRACT: . US 'tJr~~ EFFECTIVE DATE: EXPIRATION DATE: RENEWAL DATES. _~ I ALL CONTRACTS MUST BE COMPLETED A MINIMUM OF 10 DA YS PRIOR TO EFFECTIVE DATE I RESPONSIBLE DEPARTMENT: ~~~ NOTES/INSTRUCTIONS: 'M C~ ~ ~: C/'V~I D11 +v &t1Jrcl/(j ff 2]--&~ FISCAL OFFICER APPROVED OA TE RETURNED TO RESPl DATE SiGNED BY COM;..lL COri'iTY CONTR,\CT .'iUMBER: -, ~~~-~~ vVHO SHOULD RECEIVE COpy OF COlVIPLETED C()NTRACT'! (Check appropriate Offices) CLERK AND RECORDER [ORlGINAL] FISCAL OFFICER G::i -~- RESPONSIBLE DEPARTMENT HEALTH - NURSfNG COUNTY A TTOR,,'\iEY ----- HEALTH - ENVIRONMENTAL COUNTY COMMISSIONERS ~~._.,-~~ REST HorvrE -,-~~ t\SSESSOR ROAD OFFICE --- AUDITOR - C & R ACCOUNTING -- SHERIFF OFFICE - DES WEED DEPARTrvlENT _.._-~- FACILITIES INSURANCE COrvlPANY (Name): -_._'~---- Attention: "........----~~~---~_.~-~. OTHERS (Include: Entity. Mailing Address. Phone #, and Contact Person) _~___._____. ~ ~!2t~&p~) o ~::;;J~~~ 2h--46 V () 71J&ld!LY - ~~;' /)1/( 6777/ D:3~J /Y1/57/7/ O,A TE C & R DISTRIBUTED: SEPTEMBEH :3/ 1999 March 25. 1996 f:\patlcontractlcoll tch k, doc . . MODI FICA TION TO AGREEMENT DISASTER AND EMERGENCY SERVICES COORDINATOR AND HAZARDOUS MATERIALS THIS MODIFICATION TO AN AGREEMENT, is made by and between: GAI,LATIN COUNTY, 311 West Main Street, Room 301, Bozeman, Montana 59715, Telephone: 406-582-3000 ("COUNTY"); and, CITY OF BOZEMAN, 411 East Main Strect, Bozeman, Montana 59715, Telephone: 406-582-2300 ("CITY"). WHEREAS, the COUNTY and CITY entered into Gallatin County Contract 98-62 on June 13, 1997, which went into effect on July 1, 1997, regarding Disaster and Emergency Services Coordinator and Hazardous Materials ("Agreement"); and, WHEREAS, the COUNTY and CITY amended the Agreement by written modiflcations dated July 28, 1998, and Septcmber 8, 1999; WHEREAS, the parties intend to modity the Agreement to augment compensation for Fiscal Year 2001. NOW, THEREFORE, in consideration of the terms, conditions, covenants and performance contained herein, the Parties hereto agree to modity the Agreement as follows: l. All terms of the Agreement and the moditlcations referenced herein are incorporated by reference herein except the following changes shall be made: A Page 3, Section 4 of the Agreement shall be modified as follows: Compensation: The Contractor will be compensated in an amount mutually agreed upon before May 31 of each year. The FY 01 mutually agreed upon amount is $48,586 for DES activities. END OF AGREEMENT EXCEPT FOR SIGNATURE PAGE /':\IIUJ,:~n\()l r)I~S&IIM Agree Mo(htie<ltlon wpd ~ . ,.., tk d f J'/ll1v DATED this t., ay 0 _____1___ jl I ,2000. GALLATIN COUNTY CITY OF BOZEMAN COMMISSIONERS , ~ c;;/!:I rw~ ~___._._:c_:o,..._...~._ ______ --. -.-......- ~-,. -........_,~,_. Clark Johnson, City Manager Phil Olson, Chairman ATTEST: ~.:I~ y th7 ;!zY~_ ....--.- Robin Sullivan, City Clerk Jennifer Smith-Mitchell, Member APPROVED AS TO FORM: ATTEST: "7 ? .,.,"--7 ~ '- ~,-tlLIl-( . Pau Shelley Vance, C erk & Recorder Z:\IIUI..:::;"J\OI DJi::-i&IIM Agree Moditicat.ion,wpd I MODIFICA TION TO AGREEMENT DISASTER AND EMERGENCY SERVICES COORDINATOR AND HAZARDOUS MATERIALS I I THIS MODIFICATION TO AN AGREEMENT, is made by and between: GALLATIN COUNTY, 311 West Main Street, Room 301, Bozeman, Montana 59715, Telephone: 406-582-3000 ("COUNTY"); and, CITY OF BOZEMAN, 411 East Main Street, Bozeman, Montana 59715, Telephone: 406-582-2300 ("CITY"). WHEREAS, the COUNTY and CITY entered into Gallatin County Contract 98-62 on Junc 13, 1997, which went into effect on July I, 1997, regarding Disaster and Emergency Services Coordinator and Hazardous Materials ("Agreement"); and, WHEREAS, the COUNTY and CITY amended the Agrcemcnt by written modifications dated July 28, 1998, and September 8, 1999, and May 8' 2000; WHEREAS, the parties intend to modify thc Agrccmcnt to augment compensation for Fiscal Year 2003. NOW, THEREFORE, in consideration of the terms, conditions, covenants and performance contained herein, thc Parties hereto agree to modify the Agreemcnt as follows: 1. AU terms of the A,!:,Jfeement and the modifications referenced herein arc incorporated by reference hercin except the following changes shall be made: A. Page 3, Section 4 of the Agreement shall bc moditied as follows: Compensation: Thc Contractor will be compensatcd in an amount mutually agrecd upon before July 1 of each year. The FY 03 mutually agrced upon amount is $56,082.00 fl.)r DES activities. ~ END OF AGREEMENT EXCEPT FOR SIGNATURE PAGE J 60> lU"S liS 58b- ,. M ^ ~ 84'\;)COO TL.c L~-\- -r:~< C01') \ (t>>AC.~ lUAS Qt'~e~ IIUrD-SRVIUSER\SlIRAUGER\SOW\200.1 DES A(;RlEMENT MOOIFICATlON.[)<X . ~~.,. '.i. , ~".~,;.:,'.:.. . < - , I ~ I- , ,", . . . I "=., .':".'. . . #- d(JotJ,;{ I DATED this /J- day of iVcJViJm.i2!!c_, 2000. GALLATIN COUNTY CITY OF BOZEMAN COMMISSIONERS 1 \ . ~--" -~~~- ~ Clark Johnson, City Manager Jennifer Smith Mitchell, Memb! ATTEST: 9~ J 0 ,14 0 ""-- Robin Sullivan, City Clerk APPROVED AS TO FORM: ~/........../ ........~..~y.. . . - .- -<;:.:.-<..~ . ,:..:,/" /' ".,/ /" ..,/" /,. .;. k. t./ _.. .... c~t~/--.-.~_. ...__ Paul Lu,>, ' City A\tomey ~ flrTJ-SRVIl)SER\SIIRAUGERISOWlcOOJ DFS MalEf'MEi'iT .V100IFI('ATlON.fXJC ~: COUNTY CONTRACT .. II 1998-Q62A COUNTY CONTRACT NUl'vlI3ER - ~ '''_.,,'~-_.,~ COUNTY CONTRACT ROUTING FORM i DE;0j HAZIYl;\:I" ,______ CQNTRACT NAME: u_________._._____..._ ! EFFECTIVE DATE: -,-, EXPIR.A TI0N DA-rI:: --~,_.,...,., -.-- RENEWAL DATES --------- RESPONSIBLE DEPARTMENT: DES .---.....,.-. .-..." ,...---...-- NOTES/INSTRUC'lIONS:~~.\..ul'O l.;),.~~__ __ Q.\~mOD_\_~Q."--~~... I SIGNED BY OUTSIDE PARTIES: ._-~.'~--_.~- I ED)JY OLrrSIDE PARTlES: QJlINTY ...c\J_TClRNFY ,\PPROV AL AS TO IXCii\!.. CONTFN'T: . UAII~:/~-Illlfr;L~ 1-IS(',\L ClIIYTR AI'I'IWVAL AS TO ^ VAILMlIX I-UN DIN( Di\TF J;> /1'1 Ie).? =-~r:,z/)" ~f <"--'"?'L I r IJAIl': SIGNED IlY (-()M\-'IIS8Sllili~::; \<1q6_ ..OlaZA____ ;Jy> 7-;;; 54 -'I :-1:(_.-"f/ ~3'7 7 ~ \ ~ WHO SHOULD RECEIVE COPY OF COMI>LE'I'ED CONTRACT? (Check appropriate 0 ffiees) x CLERK AND RECORDEIZ [ORICiINALl l De:, / J..J-4z. /YlA--r x RESPONSIBLE DEPARTMENT HEALTII - NURSINCJ CCHJNTY ATTORNEY -- r IEALTIT - ENVIRONtvIENTAL -- COUNTY COMNIISSIONERS IZEST HOMI: FISCAL .~"-' .--.-.--- ROAD OFFICE ~--".- AUDITOR --.--...".--..".. -.. Sl jERIFF OFFICE GRANTS WEED DEPARTMENT FACIIXnES r-:Jsr.rp.../\.NCE CC:~,1P/,i';Y C~;~t21~.:): . _.___._________n ~ ---.--..-.... no . __....________.__.__...___.. Attention: ----.--.--.--- OTHERS (Include: Entity, Mailing Address, Phol1l.; ft, and Contact Person) 'Rob 10 ~\\:" ArU ( ~;.\."" Co~"": ~; oV ~ -.-. -. ...- .- - D.\TE C 8:: R DISTRIBUTED: