HomeMy WebLinkAbout2012-055 Register of Deeds - AMCAD $ Blank�
ORANGE COUNTY CONTRACT CONTROL SHEET r
Department, IT Risk Management, ent, 4 Financial Services, Attorney, Imager, 7 Clerk
.tin order: � Dip
This Document shall accompany all contracts and shall be submitted for signature in the Routing Order specified above. if the Manager
determffies the contract is not appropriate for Manager approval the Manager shall submit the contract for BOCC approval. Contracts for
B CC 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 prior to being routed for signature.
Department - 4 1B
Pa /Vendor Na e;. warty endor Contact Person: Contact Phone: Party e A dross: city
State: Zip: Department Amount: Purpose: Budget Code: den .tr 9 (NIA if new
vendor ) Vendor is a BOCC consultant? Yes ❑ No[] Contract Type: (Check one) New ❑ en iendxent [:] Effective
Date Approved by Board Yes❑ No❑ Agenda Date; Title of Contract: r
If this is a Grant Agreement, pro - application has been approved by the Board of Commissi Q S Y if submitted for bid were
bids /RFPs received Yes❑ No[] Bid RFP number This contract has been reviewed d F pr ed the Department Director as to
technical content:
Department Director
Sign ! , 9 Date.
IT Director
(Applicable only to rdwa • tw r purchases or related set- vices) This contract has been reviewed and approved by the Information
Technology Director as to technical content and information technology specifications:
I Director's g
'T
Signature: laic.
Risk Management
following coverages: F-1 L ❑ Auto; ❑ WC; ❑ Professional; ❑ N Insurance I e uire �Hold
Include the g
Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as shown, this contract is approved
by the Risk Manager:
Kish Manager's Si nature; Date:
Financial Services
This Contract is condition d upon appropriation by the Board of Commissioners Yes ❑No A budget amendment is necessary
before approval Yes❑ c If �OUdget endrnent is necessary, please attach to this form, his instrument has been pre - audited in the
manner required by the Local Government Bud e and Fiscal Conti l Act:
Financial Services Director's Signature: Date.
bez-
Co Attori
Approval by Board [:] (Contracts $90,000.00 or more for goods or services, $250,000.00 or more for construction, or any B C
consultant contract). Approval by N4janager El (All o r cunt acts). This contract has been reviewed and approved by the Attorneys as
to legal form and sufficiency:
7 1. +
Attorney's Signature Date.
County Manager
This contract has been reviewed and is approved by the County Manager Yes❑ No[].
This contract has been reviewed and is for signature by the Chair Yes ❑N ❑.
Manager's Signature: Date:
Clerk to the Beard
Approved by BC on the day of 2 0 brnitted for Chair signature on the day of ,
Clerk's Signature: Date:.
Reprised November er 013.