HomeMy WebLinkAboutHealthcare Delivery, Inc. - 081621 i(p ?).76-
PROFESSIONAL SERVI CES CONTRA CT
HEALTHCARE DELIVERY,INC.
This Professional Services C on t r a c t (the "Contract") is entered into this day of July,
2021 by and between the County of Jefferson (the "County") and Healthcare Delivery, Inc.,
dba Healthcare Delivery Systems ("HDS").
RECITALS
A. The County desires to have certain health care services requiring specialized
skills and other supportive capabilities performed as set forth in this Contract.
B. HDS is qualified and possesses the skills and capabilities to perform the health
care services set forth in this Contract and desires to perform such services for the County.
CONTRACT
NOW, THEREFORE, the parties agree as follows:
1. SERVICES.HDS shall perform the services set forth in this Contract and listed
in detail on Exhibit A attached hereto and by this reference incorporated herein (the
"Services"), including the furnishing of all equipment necessary for the performance of the
Services. HDS shall not be required to perform any services which are not specifically identified
in this Contract.
2. FACILITY; SUPPLIES. The County shall provide an appropriate medical
area in which HDS may perform the S ervices. The County shall provide all materials and
supplies necessary or desirable for HDS's performance of the Services, including,without
limitation,those items listed on Exhibit C attached hereto and by this reference incorporated
herein. The County shall provide inmate transport to and from the medical area and provide
security for all HDS staff when on site.
3. TERM. This Contract shall commence on the date hereof HDS has assumes
responsibility for providing Jail inmate medical care under this Contract commencing on
August 1,2021. This Contract shall expire on July 31,2022. This Contract shall automatically
renew for successive periods of one(1) year each unless either party has given the other notice
of termination not less than ninety(90) days prior to the then current expiration date. In no
event shall there be more than four (4) renewals without the execution of a new Contract.
4. COMPENSATION. The County will pay HDS for the performance of the
Services based on the rates and charges set forth on Exhibit B, for an annual total
compensation in the first year of this Contract not to exceed $245,680.00.The parties agree
to review the compensation, rates and charges payable to HDS on or before one hundred
twenty (120) days prior to each anniversary of this Contract. Increases shall not exceed
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5% in any given year. If the parties are unable to agree on the compensation, rates, and
charges for the succeeding one ( 1) year term, then either party may terminate this Contract
effective upon its termination date as set forth in Section 3 ofthis Contract.
5. PAYMENT. HDS will submit an itemized invoice to the County on or after
the first day of each calendar month for Services performed during the immediately preceding
calendar month based on the rates and charges set forth on Exhibit A. The invoice shall list
the dates, hours, services, and charges. The County shall pay HDS within thirty(30) days
after receipt of a correct and conforming invoice. For purposes of Compensation and
Payment, the term "due date" shall be the 30`h day after the County receives a correct and
conforming invoice. With the exception noted herein, the County shall pay a late charge of
2% of any amounts not paid on or before the due date, and any amounts not paid when due
shall accrue interest at the rate of 1% per month starting on the payment due date and
continuing until any overdue balance(s), including late charges, is/are received in full. As an
exception to the forgoing, HDS shall not be paid for services rendered under the Contract
unless and until they have been performed to the reasonable satisfaction of the County.
Moreover, in the event HDS has failed to perform any substantial obligation t o be performed
by HDS under this Contract and such failure has not been cured within ten(10) days following
notice from the County,then the County may,in its sole discretion,upon written notice to HDS,
withhold any and all monies due and payable to HDS,without penalty until such failure to
perform is cured or otherwise adjudicated. "Substantial" for purposes ofthis Contract means
faithfully fulfilling the terms ofthe Contract with variances only for technical or minor
omissions or defects.
6. CONFIDENTIAL INFORMATION. Except as required as part of the
performance of the Services, either party may disclose, and neither party shall be required to
disclose, confidential information regarding the recipient of any of the Services for any purpose
except with the written consent of the recipient or the recipient's attorney or responsible parent
or guardian, or as otherwise permitted or required by law. This Contract is a Public Record
subject to the provisions ofthe Public Records Act, Ch. 42.56 RCW.
a. "Personal information" collected, used, or acquired in connection with
this Contract shall be used solely for the purposes ofthe Contract and shall
remain the property of the County. County staff authorized to see such
information will be designated in writing by the Jail Superintendent. HDS shall
have a non-exclusive license to review, generate, and use that information during
the term ofthis Contract.
b. For purposes of this Contract, the tet in "personal information" shall
mean information identifiable to any person, including, but not limited to,
information that relates to a person's name, health, finances, education, business,
use or receipt of governmental services or other activities, addresses, telephone
numbers, social security numbers, driver's license numbers, other identifying
numbers and any financial identifiers.
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c. For purposes of this Contract, the term "personal information" also
includes "Protected Health Information" as set forth in 45 CFR. § 160.103 as
currently adopted and as may hereafter be amended or revised and other
information that may be exempt from production to the public or other
unauthorized persons under either Ch.42.56 RCW, 42 USC §§1320 et seq., 42
CFR Part 2, Chapters 70.02, 70.24, 70.96A and 71.05 RCW or other state and
federal statutes and regulations governing confidentiality and/or disclosure.
d. HDS agrees to implement physical, electronic, and managerial
safeguards to prevent unauthorized access to "personal information". The County
reserves the right to monitor, audit, or investigate the use of personal information
collected, used, or acquired by HDS through this Contract.
e. HDS agrees not to release, divulge, publish, transfer, sell, or
otherwise make known "personal information" without the express written
consent ofthe subject person, the County, or as provided by law.
f. HDS agrees to indemnify and hold harmless the County for any court
costs,attorney's fees, or damages related to or arising from HDS's unauthorized
use or disclosure of`personal information".
g. To the extent required by law, HDS shall certify the return or destruction
of all "personal information" upon expiration ofthis Contract.
h. Any breach of this Section by HDS may result in termination of
this Contract in a manner consistent with Section 15 ofthis Contract.
i. The provisions of this Section shall be included in any contract or
agreement between the HDS and any and all of the HDS's subcontractors.
7. COMPLIANCE WITH LAW. HDS shall comply with all Federal, state and
local laws and regulations applicable to the performance of the Services, including those
governing licensing, registration, and certification.
8. AMENDMENT. Any amendment or modification to this Contract must be in
writing and signed by both parties to be effective.
9. NON-DISCRIMINATION. HDS shall not,on the basis of race,color,sex,sexual
orientation,religion,national origin, creed, marital status, age, Vietnam era or disabled veteran
status, or the presence of any sensory, mental, or physical disability, deny an individual any
Services required to be provided under this Contract.
10. INDEPENDENT CONTRACTOR. This Contract establishes an independent
contractor relationship between the parties and shall not be construed to create any relationship of
partnership or joint venture. None ofthe persons performing the Services shall be deemed to be an
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employee or agent of the County for any purpose and no such person shall be entitled to any of the
benefits the County provides to its employees. Such persons are employees or agents of HDS and
HDS shall be responsible for directing and controlling such persons in the performance of the
Services and for compensating them.
11. LIMITATION OF LIABILITY; INDEMNIFICATION. HDS's liability on any
claim whatsoever for which HDS is responsible, including negligence and any damage or loss
arising out of or resulting from this Contract or the performance or breach hereof not covered,
reimbursed or paid for by the insurance maintained by or for the benefit of HDS under Section 12
of this Contract shall in no event exceed the total compensation paid to Consultant hereunder. Any
action for breach ofthis Contract must be commenced within two (2) years after the occurrence of
the event giving rise to such breach. In no event shall HDS be responsible for, or the County entitled
to recover, indirect, special, incidental or consequential damages. The County shall indemnify and
hold harmless HDS, and its employees and agents, from and against any claim, loss, liability or
damage(including attorneys' fees incurred in connection with the defense of any action based on any
such alleged act or omission, which attorneys' fees shall be paid as incurred) arising out of or in
connection with any act performed, or omitted to be performed in connection with this Contract;
provided that such indemnification and hold harmless shall not cover (i) indemnification prohibited
by law,or (ii) any act or omission of HDS amounting to an intentional breach of this Contract,
fraud, gross negligence, or willful misconduct. Without limiting the foregoing, the County will
defend, indemnify, and hold HDS and its employees and agents harmless from and against any
claim, loss, liability, or damage resulting from the failure to provide medical care, treatment,
diagnostics, or pharmaceuticals to any person where HDS has advised the County of the medical
necessity therefor.
12. INSURANCE. Prior to commencing work,HDS shall obtain at its own cost and
expense the following insurance from companies licensed in the State of Washington with a Best's
rating of no less than A:VII. HDS shall provide to the County Risk Manager certificates of
insurance with original endorsements evidencing the insurance required by this clause prior to
the commencement of the Services. If any of the insurance requirements are not complied with
at the renewal date of the insurance policy, payments to HDS shall be withheld until all such
requirements have been met, or at the option of the County, the County may pay the renewal
premium and withhold such payments from the moneys due HDS.
All notices shall name HDS and identify the Contract by contract number or some
other form of identification necessary to inform the County of the particular contract
affected.
A. Workers Compensation.HDS shall procure and maintain for the life of the
Contract, Workers Compensation Insurance, in accordance with the laws of the State of
Washington. HDS specifically assumes potential liability for actions brought against the
County by HDS's employees, including all other persons engaged in the performance of any
work or service required of HDS under this Contract and, solely for the purpose of this
indemnification and defense, HDS specifically waives any immunity under the state industrial
insurance law, Title 51 R.C.W. HDS recognizes that this waiver was specifically entered into
pursuant to provisions of R.C.W. 4.24.115 and was the subject of mutual negotiation.
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B. Commercial General Liability with a minimum limit per occurrence of
one million dollars ($1,000,000) and an aggregate of not less than two million dollars
($2,000,000) for bodily injury, death, and property damage. This insurance coverage shall
indicate on the certificate of insurance the following coverage:
Broad Form Property Damage with no employee exclusion;
Personal Injury Liability, including extended bodily injury;
Broad Form Contractual/Commercial Liability Premises - Operations
Liability (M&C);
Independent Contractors and Subcontractors; and
Automobile with a minimum limit per occurrence of$1,000,000 for
personal injury and property damage. This insurance shall indicate on
the certificate of insurance the following coverage:
Owned automobiles;
Hired automobiles; and,
Non-owned automobiles
C. HDS shall maintain in full force and effect professional liability/medical
malpractice insurance covering HDS and each of its employees and agents performing Services,
with coverage of not less than $1,000,000 in the aggregate.
Any deductibles shall be declared to and approved by the County prior to the approval of the
Contract by the County.
HDS shall include all subcontractors as insureds under its insurance policies or shall furnish
separate certificates and endorsements for each subcontractor. All insurance provisions for
subcontractors shall be subject to all of the requirements stated herein. Failure of HDS to
take out and/or maintain any required insurance shall not relieve HDS from any liability
under the Contract, or shall the insurance requirements be construed to conflict with or
otherwise limit the obligations concerning indemnification.
The County states it is a member of the Washington Counties Risk Pool (or"WCRP") and
through said membership has third-party liability coverage through the Memorandum of Li
ability Coverage ("MLC") provided to it by the W CRP in the amount of Twenty Million
Dollars ($20,000,000.00). For purposes of the MLC, HDS, its owner,any state-licensed
medical provider employed by or contracting with HDS and any employee, subcontractor
or representative of HDS shall be considered a"Protected Party" for the purposes of any
claim,lawsuit, or action arising from or proximately caused by the acts and/or omissions
of HDS during the course and scope of work perform ed by HDS in furtherance of this
Contract as more specifically described in the attached Scope of Services, Exhibit A to
this Contract. The third-party liability coverage provided by the M LC to the County shall
be primary to any professional liability/medical malpractice insurance HDS is required
to obtain and maintain pursuant to this Contract.
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13. JURSIDICTION. This Contract shall be governed by and construed in accordance
with the laws of the State of Washington. Any suit or proceeding in connection with this
Contract shall be brought and maintained only in Thurston County Superior Court.
14. ASSIGNMENT, DELEGATION, AND SUBCONTRACTING. HDS shall
perform the terms of the Contract using only its bona fide employees or agents who have the
qualifications to perform under this Contract. The obligations and duties of HDS under this
Contract shall not be assigned, delegated, or subcontracted to any other person or firm without the
prior express written consent ofthe County. HDS warrants that it has not paid nor has it agreed to
pay any company, person, partnership, or firm, other than a bona fide employee working
exclusively for HDS, any fee, commission,percentage,brokerage fee, gift, or other consideration
contingent upon or resulting from the award of making of this Contract.
15. TERMINATION. The County may terminate this Contract for convenience at any
time by giving ninety (90) days written notice to HDS. HDS may terminate this Contract for
convenience at any time by giving ninety(90) days written notice to the County. In either event,the
County shall pay HDS for all Services performed through the date of termination.
16. SEVERABILITY. If any part, term, or provision of this Contract is held to be
illegal or unenforceable, the validity of the remaining provisions shall not be affected, and such
part, term, or provision shall be deemed modified to the extent necessary to make it legal and
enforceable, but if such modification is not possible, the rights and obligations ofthe parties shall be
construed and enforced as f this Contract did not contain the particular part,term. or provision
held to be illegal or unenforceable. Notwithstanding the foregoing, if such modification or
elimination would materially and adversely alter the rights or obligations of a party, such party
may terminate this Contract by written notice to the other.
17. ENTIRE CONTRACT. This Contract is the complete expression of the parties'
agreement, and supersedes any prior or contemporaneous oral representations, understandings, or
agreements.
18. NO WAIVER. The failure of either party to insist on strict compliance with any of
the terms, covenants, or conditions of this Contract by the other party shall not be deemed a waiver
of that term, covenant, or condition, nor shall any waiver or relinquishment of any right or power
at any one time or times be deemed a waiver or relinquishment of that right or power for all or any
other times.
19. NOTICES. Any notice to be given hereunder by either party shall be in writing and
shall be deemed to be fully given on the date of service if served personally on the party to whom
notice is to be given, or on the third day after mailing if sent by certified or registered mail, return
receipt requested, at the address of the party as it appears beneath its signature below.
20. DEBARMENT. HDS certifies that is is not presently debarred, suspended or
proposed to for debarment, declared ineligible, or voluntarily excluded from participation in this
Contract by any Federal department or agency_
21. SUBSTANCE USE PROHIBITIONS. While performing services, the use of
illegal drugs, alcohol, or controlled substances on County property or premises is strictly
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prohibited. HDS's employees shall not perform services while under the influence of drugs or
alcohol, and if discovered,may be reported to the appropriate law enforcement agency.
22. TOBACCO USE. The use of tobacco of any kind on property or premises of the
County shall comply with County policies.
23. COUNTERPARTS. This Contract may be executed in one or more counterparts,
each of which shall be deemed an original, and all of which counterparts together shall constitute
the same instrument which may be sufficiently evidenced by one counterpart. Execution of this
Contract at different times and places by the parties shall not affect the validity of this Contract,
so long as all the parties execute a counterpart of this Contract.
IN WITNESS WHEREOF, the parties have executed this Contract as of the date
and year first written above.
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SIGNATURE PAGE
COUNTY:
JEFFERSON COUNTY
BOA OF MMISSIONERS
Kate an,Chair
•
He* • • nh ur,Member
_ireg ro erton, ember
ATTEST:
6aba
Carolyn Gal May,Clerk of the BoAd
Date:
A. , only:
`1-
Phi ip "unsue er
Date: August 8,2021
Chief Civil Deputy Prosecutor
County Notice Address: Jefferson County Sheriff's Office
81 Elkins Road
Port Hadlock,WA 98339
HDS:
Healthcare Delivery, Inc.
•
hannon Slack
Its: President
Notice Address: 9039 Silverspot Drive SE
Tumwater,WA 98501
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EXHIBIT A
Scope of Services:
HDS will provide inmate health care services for the Jefferson County Jail in accordance
with applicable standards of the American Medical Association ("AMA"), the State of
Washington, and the National Commission on Correctional Health Care. These include, but
are not limited to, the following:
1. Twenty-four (24)hour phone triage and consultation by an Advanced Registered
Nurse Practitioner or Medical Doctor for a monthly retainer as shown in the Compensation
Schedule with unlimited phone access. Response time will generally be within less than five
minutes of facility's call; however, due to technological problems with pagers and cell phones
on the road, it may be longer than five minutes and response time may be up to 20 minutes.
Any medical matter that requires urgent response will be promptly evaluated and managed by
phone.
2. Advanced Registered Nurse Practitioner with prescriptive privileges will attend
the Jail once each week and use telemedicine once each week,to conduct sick calls for inmates,
review all new inmate intake forms and inmate requests (kites), direct appropriate care and
"Special Needs Treatment Planning" for chronic health problems, conduct medical
history/physical exams as appropriate within NCCHC timeframes, and make referrals as
necessary to other providers. This service will be billed for a 10 hour per week minimum as
shown in the Compensation Schedule. Hours in excess of 10 hours per week will be billed
hourly as shown in the Compensation Schedule with a one hour minimum for scheduled
sessions.Unscheduled sessions will be billed a two hour minimum. Services shall also include:
(I) Weekly evaluation and ordering of necessary medical supplies and
pharmaceuticals.
(2) Utilization review of all billings.
(3) Training of Jail staff as recommended by HDS, and authorized by Jail
administration.
(4) A monthly schedule of sick call coverage will be supplied to jail administration
by the 25th for the previous month. The schedule is subject to approval by jail administration.
3. At least one day per week, and more frequently as necessary, a Psychiatric
Advanced Registered Nurse Practitioner will review inmate medical records to direct necessary
Mental Health services, prescribe and review necessary psychiatric medications, and prepare
Mental Health discharge plans prior to release of inmates with mental health conditions. This
service will be billed for a 32 hour per month minimum as shown in the Compensation
Schedule. Hours in excess of 32 hours per month will be billed hourly as shown in the
Compensation Schedule, with a one hour minimum.
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4. A Medical Doctor will visit the Jail at least once each quarter. This service
will be billed monthly at the rate of one-twelfth of the annual amount shown on Table C of Exhibit
B.
5. HDS will provide an Administrative Registered Nurse who is a Certified
Correctional Health Professional, and will provide clerical support, as necessary to administer
this Contract and to provide documentation on the adequacy of care. These services will be
billed monthly at the rate of one-twelfth of the annual amounts shown on Table C of Exhibit B.
6. Initial set up and implementation of services are included at no additional
charge, and include:
(1) Policy and procedure review, update, or development per the National
Commission on Correctional Health Care Standards (NCCHC), or WASPC Standards at no
additional charge, prior to commencing medical services. This will include a standard intake
form and screening protocols in accordance with NCCHC standards to be used by Jail staff to
record proper information on medical conditions, mental condition, and use/dependence on
drugs and/or alcohol. This section will be reviewed and updated annually with each renewal of the
agreement.
(2) Necessary medical chart format review, update, or development at no additional
charge.
(3) Offender Health Plan review, update, or development.
(4) Orientation for staff at first scheduled sick call, to include company manual with
guidelines for contacting HDS, at no additional charge.
7. As requested, onsite Registered Nurse coverage can be provided, and will be
billed hourly as shown in the Compensation Schedule with one hour minimum for scheduled
sessions.Unscheduled sessions will be billed a two hour minimum.
8. Once per billing cycle, HDS will provide statistical information on services
rendered under this agreement in the format for an excel sheet provided by the county.
9. All inmate grievances/complaints pertaining to medical treatment/services
associated with this agreement will be answered in accordance with County policy by HDS.
Monthly statistics of all grievances filed (those with and without merit) will be maintained. HDS
will implement County recommendations in any disputed grievances.
10. As requested by the Jail administration, HDS can contract negotiation for
pharmaceutical services or contract negotiations with outside providers, and provide quality
management and administrative support as requested, billed hourly as shown in the
Compensation Schedule.
11. HDS will provide documentation of current and future renewals of state
licensure, licensure and malpractice insurance as per Contract for all practitioners.
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12. Practitioners will provide specialized medical equipment necessary to perform
sick call (i.e. stethoscopes, sphygmomanometers; otoscopes, ophthalmoscopes, percussion
hammers, etc.).
13. Medical records will be maintained according to "Section 6. Confidential
Information" of the Contract, and per policy to assure confidentiality.
14. HDS health providers will promote community health and prevention of
communicable disease within the Jefferson County Jail, by providing timely and appropriate
health care and education to inmates.
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EXHIBT B
AGREEMENT PRICE,AND STAFFING PLAN
Year One
Contact Information
Healthcare Delivery Shannon Slack
Systems
9039 Silvers pot Drive SE
Tumwater WA 98501 Owner/President
(360) 742-6882
jsyoung360@gmail.com
1. Personnel Rates:
Table A:
Nursing/Registered Nurse/Staff Nurse $70.00
Provider/MSN/Advanced Registered Nurse Practitioner $125.00
Provider/MSN/Psych Nurse Practitioner $125.00
Provider/PHD/Medical Doctor $150.00
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EXHIBIT B
(Continued)
Table B Staffin
Nursin• Staff M,T,W,Th,Fri 25 1,300 $91,000.00
ARNP Two da s a week 10 520 $65,000.00
Ps ch ARNP/ARNP One da a week 8 416 $52,000.00
ARNP/RN Phone Covera•e M,T,W,TH,Fri,Sat,Sun 168 8736 $12,000.00
Table C Administrative Services
Medical Director $15,600.00
Administrator $6,720.00
Clerical $3,360.00
RFP EXHIBIT B—TOTAL COST
Administrative Cost $25,680.00
Annual Personnel Costs $220,000.00
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EXHIBITC
Jefferson County Jail will provide the following as per Contract terms:
1. A private, secure area with appropriate furniture to perform medical examinations,
as well as all necessary medical supplies. All charts, medications and medical
supplies will be appropriately secured.
2. Inmate transport to and from the medical area, and security for practitioners while
onsite medical care is being delivered.
3. Inmate transport to prescribed outpatient visits for medical, dental, or diagnostic
needs.
4. All chart forms, stationery supplies, and copy services needed for onsite medical
care.
5. An accurate scale and thermometer capable of frequent use for onsite medical care.
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JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Mark McCauley,County Administrator
FROM: David Fortino
DATE: August 16, 2021
SUBJECT: Jail Inmate Medical Services Agreement
STATEMENT OF ISSUE:
Jail Inmate Medical Services agreement between Jefferson County Jail and Health Care Delivery Systems
Inc. for purposes of providing medical services to the inmate population.
ANALYSIS:
This agreement is for a one-year term with the option of one-year renewal periods for up to four subsequent
years.
FISCAL IMPACT:
$24680.00
RECOMMENDATION:
It is recommended that the board approves this contract amendment.
REVIEWED BY:
*4.1/ 57 10 2,
�Ph • c ou>nty Administrato Date
CONTRACT REVIEW FORM
(INSTRUCTIONS ARE ON THE NEXT PAGE)
CONTRACT WITH: Health Care Delivery Systems Inc. JCSO20210803
(Name of Contractor/Consultant) Contract No,
COUNTY DEPARTMENT:
Contact Person: David Fortino
Contact Phone: 360-344-9743
Contact email: dfortino aC�.co.iefferson.wa.us
AMOUNT: $245,680.00 PROCESS: Exempt from Bid Process
Revenue: Cooperative Purchase
Expenditure: $245,680.00 _ Competitive Sealed Bid
Matching Funds Required: Small Works Roster
Sources(s)of Matching Funds Vendor List Bid
RFP or RFQ
Other:
APPROVAL STEPS:
STEP 1:DEPARTMENT CERTIFIES COMPLIANCE WITH JCC 3.55.080 AND CHAPTER 42.23 RCW.
CERTIFIED: El N/A:U David Fortino Da9ea20Yf Q8#D08 7AT00' 8/4/2021
Signature Date
STEP 2: DEPARTMENT CERTIFIES THE PERSON PROPOSED FOR CONTRACTING WITH THE
COUNTY (CONTRACTOR) HAS NOT BEEN DEBARRED BY ANY FEDERAL, STATE, OR LOCAL
AGENCY.
CERTIFIED: Q N/A: ❑ David Fortino D'y "7s�""'x°a"�4F° /
Date:2(12'•.QA.p4 t�li:5e55-0T'00' 8/4/2021
Signature Date
STEP 3: RISK MANAGEMENT REVIEW(will be added electronically through Laserfiche):
Electronically approved by Risk Management on 8/4/2021.
STEP 4: PROSECUTING ATTORNEY REVIEW(will be added electronically through Laserfiche):
Electronically approved as to form by PAO on 8/8/2021.
Nice job fixing the packet!
STEP 5: DEPARTMENT MAKES REVISIONS & RESUBMITS TO RISK MANAGEMENT AND
PROSECUTING ATTORNEY(IF REQUIRED).
STEP 6: CONTRACTOR SIGNS
STEP 7: SUBMIT TO BOCC FOR APPROVAL
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