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HomeMy WebLinkAboutNW Vital RecordsToday's Date 01/24/2018 Fund/Department 116 -Public Health Kittitas County Review Form Grants & Contract Agreement [Agenda Date pis n• is.. •e;,= X45 1 Contract/Grant Information Contract /Grant Agency: Northwest Vital Records and KCPHD Period Begin Date: 02/01/2019 Period End Date: 02/28/2019 Total Grant/Contract Amount: $68.00 Grant/Contract Number: Contract/Grant Summary: The Northwest Vital Records agreement will allow them to take old xrays from the department and shred them and send us confirmation of shredding services provided. Recommendation for Board of Health and Board of Health Review on Department Head Signature: Administrator Date: Kittitas County Prosecutor, Auditor, and Board of Health Review and Comment: AEJLIQ ° D AS TO FORM. i Signatur f Pr secutor's Of ce Date Signatiur of+' uditor's Office Date Signature of Board of Health member Date Financial Information Total Amount $ 68 (expense) State Funds $ 0 Federal Funds $ 0 Percentage County Funds Matching Funds $ CFDA# In -Kind $ Explain Is Equipment being purchased? Who owns equipment? Grant/Contract Review Page 1 New Personnel being hired? I Contact HR hiring — reporting requirements Future impacts or liability to Kittitas County: Budget Information Budget Amendment Needed? New Division Created? Revenue Code n/a Expense Code: Yes ❑ attach budget form 116.611.54127 Pass Through Information Agency to Pass Through Amount to Pass Through $ Sub -Contract Approved Date: No ® Why not PH Admin Shreddi Prosecutor Review Has the Prosecutor reviewed this agreement? Yes❑ No County Departments Impacted Submitted Signature: Department: Assignment of Tracking Information Auditor's Office Human Resource Prosecutor's Office Who Signed the grant application Reviewer I Date Grant/Contract Review Page 2 Auditor Facilities Maintenance Information Services Human Resource Prosecutor Treasurer Submitted Signature: Department: Assignment of Tracking Information Auditor's Office Human Resource Prosecutor's Office Who Signed the grant application Reviewer I Date Grant/Contract Review Page 2 DESTRUCTION SERVICE CONTRACT Northwest Vital Records Center will provide the service of document destruction and provide a collection bin(s) at no charge. Bins remain the property of Northwest Vital Records Center. Customer KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT 9-0- W p W 507 NORTH NANUM ST, SUITE 102 ELLENSBURG, WA. 98926 Billing Address Bin Address Contact LIZ 509-962-7068 Phone Number Service Start Date FAX -NUMBER # of Containers: — Service Fee "18.00 FLAT RATE PER BIN 1 BOX X-RAYS $50.00 _1 Pick -Up Service On -e— -Fm Authorized Signature X GG Printed Name LIZ- I/1i kl Ke,k-- k SS Date Northwest Vital Records Center Date JOE M. LENZ 12/3/18 Terms & Conditions 1. Services to be Furnished. Company will provide service for the destruction of records `Services"). Company will provide a certificate of destruction to Customer, upon request by ;;, omer. The Services may, at Customers Option, be performed as part of a regular schedule or pursuant to specific directions which Customer shall give Company from time to time. Customer may also request additional services not set forth in the agreement, in which case Company will consult with Customer as to the terms and conditions of such Services. Z. Right to Rely on Instructions. Company may act in reliance upon any instruction, i;,,jtrument or signature reasonably believed by Company to be genuine, and may assume that any of Customer's employees or any employee of Customer's affiliates or subsidiaries, or any other person in possession of Customer's records, giving any written notice, request or instruction has the authority to do so. 3. Hazardous Substances. Customer shall not deliver to Company any material considered to be dangerous or which is regulated under any federal, state or regulations relating to hazardous material, including regulated waste or bio -hazard. In the event the Customer does deliver to the Company any such material, Customer shall arrange its retrieval appropriately, safely and legally, assuming custody of such material and at its expense, and further indemnify Company from any property damage or personal injury resulting from or related to such delivery. 4. Bins. Any and all collection bins provided by Company will remain the property of the Company as well as all material enclosed within the bins for shredding, including but not limited to, the right to recycle the material. 5. Service Fee. The service fee will be listed on the front of this agreement and will remain in effect for the term of this agreement. Any changes in this fee will require written approval by both the Customer and Company. 6. Failure to Pay. In the event the Customer fails to pay any amounts owing under this Agreement, when due, including by reason of bankruptcy or insolvency, the Company may immediately cancel this Agreement and retrieve its equipment from the Customer, wherever located. In the event the Company takes action pursuant to this section it shall have no liability to the Client or anyone claiming by or through the client. Nothing herein shall preclude the Company from pursuing other remedies by statute or otherwise. 7. Term of Agreement. This Agreement shall automatically be renewed for successive terms of (1) one year until either party shall cancel it by giving the other written notice of its election to cancel, at least (90) days prior to the expiration of the then existing term of (1) one year. 8. Indemnification. The Client agrees to fully indemnify and hold harmless the Company, its officers, employees and agents for any liability, cost or expense, including reasonable attorneys' fees that the Company may suffer or incur as a result of claims, demands, cost or judgments against it arising out of its relations with the Client or third parties pursuant to this Agreement, unless caused by negligence of the Company. 9. Modification -Assignment. This agreement binds the heirs, executors, administrators, successors and assigns of the respective parties and cannot be changed orally. This Agreement may not be assigned by either party (other than to an affiliate) without written consent of both parties, which shall not be unreasonably withheld or delayed. 10. Miscellaneous. This document contains the entire understanding of the parties concerning the subject matter of this Agreement. If any provision is held invalid, the other provisions of this Agreement will remain in full force and effect. The Agreement will be interpreted under the laws of the province/state in which it is executed.