Washington County ~ IG234004 ~ Towing and Abandoned Parking Program Amendment DocuSign Envelope ID:73265CEF-2EB8-46A7-BODB-E6A051 F239D3
8/25/2021
Alik
v WASHINGTON COUNTY OREGON Contract No: 21-1992
MOU AMENDMENT No: 1
This Amendment is made and entered into, by and between Washington County, a political subdivision of the State
of Oregon, and City of Tigard .
This amendment modifies that certain contract between the parties,the original contract number being
20-1939 •
The MOU is amended as follows:
1) The Agreement is extended two years, the expiration date is December 31, 2023 unless otherwise amended.
2) The annual reimbursement maximum for the term of this Amendment that the City agrees to reimburse to tow
companies is $750 for each abandoned/parking violation tow the City ordered that meets the reimbursement
criteria. The revised rate is in effect beginning 1 January 2022.
3) Exhibit revisions are attached:
a) Exhibit 1 is revised to a reimbursement maximum of$750. (Attached).
b) Exhibit 2 is revised, 2022-2023 Annual Cap Chart. (Attached)
Effective Date of Amendment: December 1,2021, or upon final signature, whichever is later. All other terms and
conditions of the original agreememnt shall remain in full force and effect.
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Authorized ignature Dat Printed Signatory Name
C l et-F- Pot% SO3 - 1i?- 257c
Title Telephone
E-Mail Address J
caclisTINTY::
(, 17
12/16/2021 1 16:10 PST Deputy County Administrator
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Authorized Signature Date Printed Signatory Title
FOR WASHINGTON COUNTY USE ONLY
County Contract Administrator: Melaney Koch Phone: 503-846-2741 Email: Melaney_koch@co.washington.or.us
2021 WASHINGTON COUNTY CONTRACT STANDARD AMENDMENT
DocuSign Envelope ID:73265CEF-2EB8-46A7-BODB-E6A051F239D3
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WASHINGTON COUNTY
CONSERVING THE PEACE THROUGH VALUES DRIVEN SERVICE/SHERIFF PAT GARS T..T
Abandoned/Parking Violation RV Reimbursement Request
To: Washington County Sheriff's Office Tow Coordinator Fax: (503) 846-2719
Tow Company:
Date request submitted:
Vehicle license plate or VIN:
Date of tow:
Include the following documentation with your request:
❑ Receipt showing cost of disposal
❑ Copies of notification(s) sent to vehicle owner
❑ Photos of vehicle
O Photos of garbage/hazardous materials (when applicable)
Description of garbage or hazardous materials:
Law Enforcement Agency Use Only:
❑ Vehicle tow was ordered by (agency).
❑ Receipt showing cost of disposal was provided.
❑ Copies of correspondence attempts sent to vehicle owner was included.
❑ Verify in DMV that the vehicle owner matches the owner notification provided.
❑ Photos of vehicle were provided.
❑ Photos including garbage/hazardous materials were provided (when applicable).
Upon review, request is:
❑ Approved and submitted for $ payment on . Max reimbursement
amount is$750.If disposal was less than$750,payment will be in the amount of disposal.
O Denied due to:
Request reviewed by: Date:
215 SW Adams Avenue, MS #32 - Hillsboro, OR 97123-3874
phone 503-846-2700 • fax 503-846-2719 • www.WCSheriff-OR.com
DocuSign Envelope ID:73265CEF-2EB8-46A7-BODB-E6A051F239D3
2022-2023 —ANNUAL CAP CHART
Reimbursing $750 (or the actual disposal cost if it is less than $750)
AGENCY MAXIMUM CAP MAXIMUM
ON ANNUAL CAP ON
REIMBURSEMENT ANNUAL
Tows
Banks PD $750 1
Beaverton PD $12,000 16
Cornelius PD $1,500 2
Forest Grove PD $1,500 2
Gaston PD $750 1
King City PD $1,500 2
North Plains PD $750 1
Sherwood PD $750 1
Tigard PD $4,500 6
Tualatin PD $3,000 4
WCSO $15,000 20
DocuSign Envelope ID:73265CEF-2EB8-46A7-BODB-E6A051F239D3
For Administrative Use Only—Z99999
Supplier Name: City of Tigard
Actual Contract Number(CustomText4):21-1992
Department(Location): Sheriffs Office
Contract Type: 6 Amendment
Contract Sub Type(Custom2Code):
Minute Order Date:
Minute Order Number:
Master Contract Number(CustomTextl): 20-1939
Bid/RFP#(BidRFP):
BPO Number(Custom1 Code): $0 or Not Applicable
SHIP TO(LocShipTo): Sheriffs Office
BILL TO(LocBillTo): Sheriffs Office
Project Number(CustomText2):
Chargeable Program Number(ChargeProgram):
Contract Admin(Administrator): John Styer
2019 WASHINGTON COUNTY-ARCHIVE RECEIPT
DocuSign
Certificate Of Completion
Envelope Id:73265CEF2EB846A7B0DBE6A051F239D3 Status:Completed
Subject: Please DocuSign:21-1992:City of Tigard
Source Envelope:
Document Pages:4 Signatures: 1 Envelope Originator:
Certificate Pages: 1 Initials:0 Connie Wilson
AutoNav: Enabled 155 N. First Ave,Suite 270
Envelopeld Stamping: Enabled MS28
Time Zone: (UTC-08:00)Pacific Time(US&Canada) Hillsboro,OR 97124-3087
Connie_Wilson@co.washington.or.us
IP Address:204.147.152.5
Record Tracking
Status:Original Holder:Connie Wilson Location: DocuSign
12/16/2021 2:28:10 PM Connie_Wilson@co.washington.or.us
Security Appliance Status:Connected Pool:StateLocal
Storage Appliance Status:Connected Pool:Washington County Location: DocuSign
Signer Events Signature Timestamp
Erin Calvert ,—Docosignedby: Sent: 12/16/2021 2:30:10 PM
Erin_Calvert@co.washington.or.us friI't' l Viewed: 12/16/2021 4:10:34 PM
\--7CE70623E43542D...
Deputy County Administrator Signed: 12/16/2021 4:10:44 PM
Washington County,Oregon
Security Level: Email,Account Authentication Signature Adoption: Pre-selected Style
(None),Access Code Using IP Address:204.147.152.15
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 12/16/2021 2:30:10 PM
Certified Delivered Security Checked 12/16/2021 4:10:34 PM
Signing Complete Security Checked 12/16/2021 4:10:44 PM
Completed Security Checked 12/16/2021 4:10:44 PM
Payment Events Status Timestamps