2010 Kittitas Co Purchasing agreement State Washington

Home Browse Search

Cooperative Member contact information: Contact Person to whom contract documents and related communications are to be mailed or faxed. Cooperative Member Agency Name: _______Kittitas County________________________ Agency Federal TIN #: ______91-6001349____________________________________ Contact Name: ___________Judy Pless____________________________________ Address: ___________205 West 5th- Suite 105_____________________ City, St. Zip _______Ellensburg WA 98926______________________________ Phone Number: ______509-962-7502________Fax Number: _____509-962-7687___ Email Address: _______judy.pless@co.kittitas.wa.us_____________________ Secondary Contact: Name: __Auditor Accounting_____Email:_auditorsaccounting@co.kittitas.wa.us Two-Year Membership Fee Schedule Note: Total expenditures listed below are minus of debt service and inter-fund transfers Annual expenditures of more than Annual expenditures of less than Two-Year Membership Fee Verified Fee Level $0.00 $3,000,000 $400 $3,000,001 $7,500,000 $1,000 $7,500,001 $30,000,000 $2,000 $30,000,001 $68,000,000 $4,000 ______jp $68,000,001 $90,000,000 $6,000 $90,000,001 $150,000,000 $8,000 $150,000,001 and over $10,000 According to the most recent authoritative information; KITTITAS CO, your annual operating expenditures were $36649831 making your two-year fee $4000. The undersigned has read, understands and agrees to the terms and conditions of this Agreement, certifies that he/she is the Authorized Signatory for the Cooperative Member, and certifies under penalty of perjury under the laws of Washington State that the verified expenditure in the Membership Fee Schedule above is true and correct. Cooperative Member Authorized Signature: Signature: ___________________________________________________Date Signed: __December 15, 2009__ Print Name: __Alan Crankovich ________________________Title: Chairman, Board of County Commissioners Address (if not the same as above): _________________________________________________________ Phone Number(s): ______509-962-7508_____________________________________________________ FOR OSP USE ONLY (Completed by OSP, this page will be returned to you in executed copy) Approved as to form: AAG Date: 10/16/2009 (signature on file) Your assigned Co-op member number is ______________. Please provide this number to vendors when ordering from contracts or communicating with OSP. OSP AUTHORIZED SIGNATURE _______________________________________________________ Verification Used:_______________ Name Title Date