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CITY . <br /> 1611 <br /> __----- , ritun r <br /> PEI <br /> 2 S ..k it 161 mu CHANCE, <br /> ISDE <br /> ts.r..fyu. OREGON <br /> (r- <br /> . Transfer Vaccination Eligibility A�reement. HUMANE <br /> '�•r SOCIETY <br /> I <br /> Partner Requirements <br /> Partners are required to be a registered 501(c)3,veterinary hospital or municipal organization. <br /> Humane standards of care must be provided to every animal being transported.(Reference addendum 5). <br /> Submitted a signed copy of the Second Chance Transfer Vaccination and Eligibility Guidelines Agreement <br /> prior to transport. . <br /> If you ave any questions or concerns about your organizations ability to adhere to these guidelines <br /> please contact the Second Chance Coordinators at:SecondChance@oregonhumane.org <br /> l <br /> Acknowledgement <br /> 9 <br /> This ay1 eement is made by and between: - <br /> 1._City f Everett Animal Shelter [printed organization name of Source Shelter]. a 501(c)(3)non-profit or <br /> municip I organization.incorporated in the State of Washington [state of incorporation] <br /> ("the Sol rce Agency")with the following address: <br /> 333 S Ith Island Road, Everett, WA 98201 <br /> [printed address. city, state, and zip code of organization] <br /> And; I <br /> 2. Oregon Humane Society, a 501(c)(3) non-profit organization, incorporated in the State of Oregon <br /> ("the Destination Agency')with the following address: 1067 NE Columbia Blvd.. Portland, Oregon. 97211 <br /> IN WITNESS WHEREOF.the parties have, by their authorized agents, signed and delivered this Agreement as of the <br /> date of the last signature below. <br /> SOURCE Agency: Everett Animal Shelter DESTINATION Agency: Oregon Humane Society'\ <br /> Tax ID#:' 916001248-, Tax ID#:93-0386880 j• <br /> Authorized Signer: , -- , Authorized Signer: - `- - % • = - • l - <br /> Print Name: *Massie F lin Print Name:Jessicaley Kruger _ <br /> Title: Mayo . Title:Admissions Manager <br /> Dated: -- i/1 i Dated: -- 2-LO -- t Cj <br /> By signing this you are agreeing to the conditions within this document, <br /> non-adherence to these terms may result in the inability to maintain transport partnerships. <br /> A'PROVED AS TOj OM ATI,' T:- 4 <br /> f ii! .4 U 1`� / <br /> JAMES D.ILE ,CI Attu.ey "' /A4 <br /> ' '4+` ' �- <br /> City Clerk <br /> 3 <br /> 1-- <br />