HomeMy WebLinkAboutA-05-400 DPH Misc. Docs.pdf COUP
CONTRACT STATUS FORM
DATE: December 01, 2023 RECEIVED
DIVISION(S): Emergency Services
FEB 21
(Lead Division listed first) DEPARTMENT OF PUB IC T
CONTRACTS SE N
CONTRACTOR: Community Regional Medical Center
SERVICES: Voice Print Access to County's EMS Communications
CONTRACT TERM: 8/30/05 to 6/30/24 E
ADDITIONAL INFO: Evergreen Agreement-Please Review
ORGANIZATION #(s): 56201693
CONTRACT AMOUNT: $624.00
Contract#: A-05-400 State/Vendor#: N/A
Lead Dept: DPH Other Dept(s):
Complete the information below and return to DPH Contracts by:March 1, 2024
Extend contract through: , 20
❑ With no changes in terms or conditions.
❑ With the following change(s):
Evergreen: Continue contract through: ��io , 20 L�
Cancel contract effective: , 20
❑ Additional Information (e.g., anticipated effective date/term, contract extension, etc.):
Approved by: �2
,.
Program Supervisor/Staff Analyst: z
� Date:
Division Manager: Date:
Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor- Phone #: 600-7090
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CONTRACT STATUS FORM
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DATE: December 01, 2022 RECEIVE �xES�
DIVISION(S): Emergency Medical Services CC8 "� 2023
(Lead Division listed first) `L H
ZMEN�OE POg�(IONA
CONTRACTOR: Community Regional Medical Center p�PR04N�RpOjSSEC
SERVICES: Voice Print Access to County's EMS Communications
CONTRACT TERM: 8/30/05 to 6/30/23 E
ADDITIONAL INFO: Evergreen Agreement-Please Review
ORGANIZATION #(s): 56201693
CONTRACT AMOUNT: $624.00
Contract#: A-05-400 StateNendor#: N/A
Lead Dept: DPH Other Dept(s):
Complete the information below and return to DPH Contracts by:March 1, 2023
Extend contract through: , 20
With no changes in terms or conditions.
❑ With the following change(s):
Evergreen: Continue contract through: 20 Zy
Cancel contract effective: , 20
❑ Additional Information (e.g., anticipated effective date/term, contract extension, etc.):
Approved by. /�
Program Supervisor/Staff Analyst: 1�2� ` Date:
Division Manager: Date:
Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor- Phone #: 600-7090
00 COUP
CONTRACT STATUS FORM
DATE: December 01, 2021 RECEIVED
DIVISION(S): Emergency Medical Services DEC 0 7 202
(Lead Division listed first)
CONTRACTOR: CommunityRegional Medical C&T9,�t�1MENT CT PUBLIC LTH
9 `CONTRACTS SECTION
SERVICES: Voice Print Access to County's EMS Communications
CONTRACT TERM: 8/30/05 to 6/30/22 E
ADDITIONAL INFO: Evergreen Agreement-Please Review
ORGANIZATION #(s): 56201693
CONTRACT AMOUNT: $624.00
Contract#: A-05-400 State/Vendor#: N/A
Lead Dept: DPH Other Dept(s):
Complete the information below and return to DPH Contracts by:March 1, 2022
❑ Extend contract through: , 20
❑ With no changes in terms or conditions.
❑ With the following change(s):
® Evergreen: Continue contract through: Ob 20
❑ Cancel contract effective: , 20
Additional Information (e.g., anticipated effective date/term, contract extension, etc.):
Approved by.
Program Supervisor/Staff Armly Date: 1 Z l 7/ L I
Division Manager: Date: 1217 ILI
Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor - Phone #: 600-7090
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CONTRACT STATUS FORM � CO
RECEIVE� g6 0
DATE: December 01, 2020 ESQ
JAN 14 2021
DIVISION(S): Emergency Medical Services DEPARTMENT OF PUBLIC HEA
(Lead Division listed first) CONTRACTS SECTION
CONTRACTOR: Community Regional Medical Center
SERVICES: Voice Print Access to County's EMS Communications
CONTRACT TERM: 8/30/05 to 6/30/21 E
ADDITIONAL INFO: Evergreen Agreement-Please Review
ORGANIZATION #(s): 56201693
CONTRACT AMOUNT: $624.00
Contract#: A-05-400 State/Vendor#: N/A
Lead Dept: DPH Other Dept(s):
Complete the information below and return to DPH Contracts by:March 1, 2021
Extend contract through: , 20__
❑ With no changes in terms or conditions.
With the following change(s):
vergreen: Continue contract through: Z.,P 4 , 20 ZZ
❑ Cancel contract effective: , 20
Additional Information (e.g., anticipated effective date/term, contract extension, etc.):
Approved by:
Program Supervisor/Staff A lyst. Date:
Division Manager: - Date: �/ Z
Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor- Phone #: 600-7090
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OwrNTRACT STATUS FOwM
DATE: December 02, 2019 FxES�
DIVISION(S): Emergency Medical Services RECEIVED
(Lead Division listed first) JUN 2 3 2020
CONTRACTOR: Community Regional Medical Center DEPARTMENT OF PUBLIC HEAL.
CONTRACTS SECTION
SERVICES: Voice Print Access to County's EMS Communications
CURRENT PERIOD: 8/30/05 to 6/30/20 E Auto-renewal;, f rough:
(If not checkmarked above,contract will terminate
ENTIRE TERM: 8/30/2005 to Ev�jeen at the end of the current period.)
ORGANIZATION #(s): 56201693
CONTRACT AMOUNT: $624.00
ADDITIONAL INFO: Evergreen Agreement-Please Review
Contract#: A-05-400 State/Vendor#: N/A
Lead Dept: DPH Other Dept(s):
Complete the information below and return to DPH Contracts by:March 1, 2020
Renew contract through: , 20
With no changes in terms or conditions.
With the following change(s):
Evergreen: Continue contract through: 20
❑ Cancel contract effective: , 20
Additional Information (e.g., anticipated effective date/term, contract extension, etc.):
Approved by.-
Program Supervisor/Staff lyst: n/ Date: /
Division Manager: l// Dater l��lCna zo
Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor - Phone #: 600-7090
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COMTRACT STATUS FOA
O� s6 O
DATE: November 29, 2018 RECEIVED FRESH
DIVISION(S): Emergency Medical Services DEC 0 6 �018
(Lead Division listed first)
CONTRACTOR: Community Regional Medical Center DEPARTMENT OF PUBLIC HEALT
CONTRACTS SECTION j�
SERVICES: Voice Print Access to County's EMS Communications
CURRENT PERIOD: 8/30/05 to 6/30/2019 E Auto-renewal: ❑ through:
(If not checkmarked above,contract will terminate
ENTIRE TERM: 8/30/2005 to Evergreen at the end of the current period.)
ORGANIZATION #(s): 56201693
CONTRACT AMOUNT: $624.00
ADDITIONAL INFO:
Contract#: A-05-400 State/Vendor#: N/A
Lead Dept: DPH Other Dept(s):
Complete the information below and return to DPH Contracts by:March 1, 2019
Renew contract through: , 20
❑ With no changes in terms or conditions.
❑ With the following change(s):
Evergreen: Continue contract through: 20
Cancel contract effective: , 20
❑ Additional Information (e.g., anticipated effective date/term, contract extension, etc.):
Approved by:
Program Supervisor/Sta nalys Date: 1 -2-
Division Manager: Date:
Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor - Phone #: 600-7090
qW COUP
CONTRACT STATUS FORM
EIVED
DATE: December 01, 2017 JAN 2 3 2018 ESQ
DIVISION(S): Emergency Medical Services DEPARTMENT OF PUBLIC H
(Lead Division listed first) CONTRACTS SECTION
CONTRACTOR: Community Regional Medical Center
SERVICES: Voice Print Access to County's EMS Communications
CURRENT PERIOD: 7/1/17 to 6/30/2018 E Auto-renewal: ❑ through:
(If not checkmarked above,contract will terminate
ENTIRE TERM: 8/30/2005 to Evergreen at the end of the current period.)
ORGANIZATION #(s): 56201693
CONTRACT AMOUNT: $624.00
ADDITIONAL INFO: County receives a $208 (one time) access fee from each of 3 hospitals partici
Contract#: A-05-400 State/Vendor#: N/A
Lead Dept: DPH Other Dept(s):
Complete the information below and return to DPH Contracts by:March 1, 2018
Renew contract through: , 20 .
With no changes in terms or conditions.
With the following change(s):
I;kl
Continue contract through: 20
Cancel contract effective: , 20
Additional Information (e.g., anticipated effective date/term, contract extension, etc.):
Approved by:
Program Supervisor/Staff al Date:
4Division Manager: Date:
Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor - Phone #: 600-7090
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C*MTRACT STATUS F0*+d
O� g6 O
DATE: November 20, 2015
DES
DIVISION(S): Emergency Medical Services 7 �G15
(Lead Division listed first)
ARih1ENY OF PUBLIC NE�LTII
CONTRACTOR: Community Regional Medical Center-' ^,NORACTS SEC110ti
SERVICES: Voice Print Access to County's EMS Communications
CURRENT PERIOD: 7/1/15 to 6/30/16 E Auto-renewal: ❑ through:
(If not checkmarked above,contract will terminate
ENTIRE TERM: 8/30/2005 to Evergreen at the end of the current period.)
ORGANIZATION #(s): 56201693
CONTRACT AMOUNT $624.00
ADDITIONAL INFO:
Contract#: A-05-400 State/Vendor#: N/A
Lead Dept: DPH Other Dept(s):
Complete the information below and return to DPH Contracts by:March 1, 2016
0"Renew contract through: XQ l (? 20 .
LKith no changes in terms or conditions.
With the following change(s):
Evergreen: Continue contract through: 20
❑ Cancel contract effective: , 20
❑ Additional Information (e.g., anticipated effective date/term, contract extension, etc.):
Approved by:
Program Supervisor/Staff Ana ly Date:
Division Manager: Date: Z l /
Submit to: DPH Contracts - Stop #147 - Brix Building, 6th Floor - Phone #: 600-7090