HomeMy WebLinkAbout2012-036 Co Attorney - Coleman, Gledhill, Hargrave, Peek, Merritt $5,000ORANGE COUNTY—CONTRACT CONTROL SHEET
Routing Order: 1 Department, 2 IT, Risk Management, Financial Services, Attorney, Manager, Clerk
This Document shall accompany all contracts and shall be submitted for signature in the Routing Order specified above. If the Manager
determines the contract is not appropriate for Manager approval the Manager shall submit the contract for BOCC approval. Contracts for
BCC approval must be submitted through, and complete, the routing process Prior to agenda review. Contracts for legal review should
be completed through the legal review process prier to being routed for signature.
Department
Party ondor Za ne; ole nan Gledhill H r rage, Peel, 11e -rift Party /Mender Contact Person: Geof Gledhill Contact Phone: 732-
PartyNendor Address; 129 E. Tryon St City Hillsborough State; NC Zip: 27278 Department; County Attorney Amount: $5,000
Purpose; Consuldn Budget Code(s): 10205020-630000 Vendor (NA if n w ven or ender is a BOCC
consultant? Yes 1:1 NoZ Contract Type: (Check one) New ❑ renewal 0 Amendment ❑ Effective Date January 1, 2012
Approved by Board Yes❑ Igo❑ Agenda Date: Title of Contract:
If this is a Grant Agreement, pre - application has been approved by the Board of Commissioners Yes❑ No❑. if submitted for bid were
bidsFPs received Yes❑ loo❑ id`P number This contract has been reviewed and approved by the Department Director as to
technical content:
Department Director's Signature: Date:
15�/
IT Director
(Applicable only to hardwarelsof4vare w-chases r related t r .s ) This contract has been reviewed and approved by the Information
Technology Director as to technical content and information technology specifications:
IT Director's Signature;
Date:
Risk ana ernen
Include the following coverages; Ej L; ❑ Auto; ❑ WC; Z Professional; Ej Property; OR No Insurance required ❑. Hold
Contract pending receipt of Certificate of Insurance E]. With incorporation of Insurance Provisions as shown, this contact is approved
by the Risk Manager:
'o211
Disk Manager , Signature:
Date. �
Financial Services
This Contract is conditionedd upon appropriation by the Board of Commissioners Yes❑NO. A budget amendment is necessary
before approval Yes❑ NoO. If budget amendment is necessary, please attach to this form. This instrument has been fare- audited in the
manner required by the Local Government Budget and Fiscal Control Act:
i
Financial Services Director's Signature: -'`-- Date: �`-
ounty Attorne
Approval by Board ❑ (Contracts 0,000.00 or more for goods or services, $250,000.00 or more for construction, or any BOCC
consultant contract). Approval by Manager (All other contracts). This contract has been reviewed and approved by the Attorney as
to legal form and sufficiency:
Attorney's Signature Date
C�z /
County Manager
This contract has been reviewed and is approved by the County Manager ss[:fo❑.
This contract has been reviewed and is for signature by the Chair : es❑Ioo'.
4 .
Manager's Signature: Date:
Clem he Board
Approved by BC on the day of , 20 Sub itte for Chair signature on t c clay of 20 �.
Clerk's Signature:
Date. L/
Revised November 2011