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FOR CONTRACT UNIT USE ONLY <br /> ,*isS,, HUMAN SERVICES DEPARTMENT <br /> DOWNLINE TRACKING SHEET Electronic Document Path: <br /> S:\\Admin\Staff\ContractProcessor\Contracts\ <br /> (All lines must contain information or N/A) <br /> CONTRACT NUMBER: HCS-18-70-1803-198 DIVISION: H&CS <br /> AMENDMENT NUMBER: HCS-18-70-1803-198 (2) PROGRAM: OCHS <br /> AGENCY: City of Everett STAFF\ EXT: Tyler Verda ext. 2904 <br /> UPLINE 1/10th of 1%Sales Tax <br /> DESCRIPTION(S): <br /> UPLINE NUMBER(S): N/A UPLINE STATUS: 0 Executed 0 Pending <br /> ACTION TAKEN DATE INITIAL <br /> PROGRAM: <br /> Prepare Contract/Amendment ? / fn i>" <br /> Basic Agreement Executed: ® Yes ❑ No <-'W cd <br /> Status Determination/Debarred Status -y • , ‘,/ <br /> *Is "No Service Disruption Guarantee" (Exhibit E) required? <br /> ❑ Yes ® No / /2) # 1_ <br /> **If yes, is Labor Harmony Plan required? 0 Yes ® No 9.411MA►r 7 1,7 <br /> Email Contract Hyperlink to HSD.Contracts@snoco.org 1 ` `L/ <br /> Supervisor Review • <br /> • <br /> Division Manager Review //—L -1r <br /> FISCAL: <br /> Fiscal Review I 113 // g .?e,- <br /> Fiscal Risk Assessment Completed I-- 4- <br /> CON.111A5T PROCESSING: <br /> Proofe Returned to Supervisor for Revisions /g/if/f C( —.__ <br /> A proved with Revisions — — <br /> Log in Contract(Signature Authorization Form on file?) /a../.1// - f.ci,,� <br /> Send to PA for Review <br /> Received from PA ✓ ✓--- <br /> -' <br /> Saved as pdf File/Copy for Pending File -- <br /> Email Contract to Agency <br /> 1"111"1111-J� .-..-- <br /> Email to Risk Management Ili pproved 47 ,..-5,./e .3/q /iT- A:,,...._.______ <br /> Received Signature Sheets Back from Agency u /4 _ <br /> *Is LHP/CBA Submitted? (See** above) <br /> Attachment A rec'd: ❑ signed 0 initialed 0 LHP DCBA �— <br /> UPLINE EXECUTED/RISK MANAGEMENT APPROVAL OF INSURANCE? IF SO: <br /> To Director for Signature i_/L//l r <br /> ht-,.„-- <br /> Contract Executed/Letter Mailed to Agency <br /> Email to Staff that Contract is Executed /d./5-/1 1---,,L <br /> Original Contract to Fiscal/Electronic Working Copy Saved S / 5--- <br /> Director Signs All Downline Contracts <br /> *Applicable to all 1/10th of 1% Sales Tax contracts`//�� and amendments and�� private sector providers of homecare services. <br /> Revised 2/23/2016 S:/CONTRRCT`FCE 8g&C1Corttract DocumentsfTrackingSheet_Downline-PINK.docx <br />