HomeMy WebLinkAbout2012-186 S Agreement Human Resources & Triangle J Council of Government $45,000r8(,
ORANGE COUNTY - CONTRACT CONTROL SHEET
Routing Order: (1) Department, (2) IT, (3) Risk Management, (4) Financial Services, (5) Attorney, (6) Manager, (7) 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
BOCC 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
Party/Vendor Name: Triangle J Council of Governments Party/Vendor Contact Person: Kirby Bowers Contact Phone: 919 -558 -2706
Party/Vendor Address: PO Box 12276 City RTP State: NC Zip: 27709 Department: Housing/Human Rights and Community
Development Amount: $45,000 Purpose: CDBG NC Tomorrow Budget Code(s): Vendor # (N /A if new vendor)
Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ Amendment ® Effective Date
06/20/2012 Approved by Board Yes® No[] Agenda Date: 05/01/2012 Title of Contract: Services Agreement
If this is a Grant Agreement, pre - application has been approved by the Board of Commissioners Yes❑ No[]. If submitted for bid were
bids/RFPs received Yes❑ No❑ Bid/RFP number This contract has been reviewed and approved by the Department Director as to
technical content:
Department Director's Signatur Date:
I irec r
(Applicable only to hardware/software purchases or related service is contract has been reviewed and approved by the Information
Technology Director as to technical content and information techn pecifications:
IT Director's Signature: Date:
Risk nagdment
Include the following coverages: ® CGL; ❑ Auto; ❑ WC; ❑ fessional; ❑ Pro e
p riy; ❑ OR No Insurance Required ❑. Hold
Contract pending receipt of Certificate of Insurance E]. With in rp ation of Insurance provisions as shown, this contract is approved
by the Risk Manager:
Risk Manager's Signature: Date:
Financial Services
This Contract is condition on appropriation by the Board of Commissioners Yes ❑No A budget amendment is necessary
before approval Yes❑ No L&. If budget amendment is necessary, please attach to this form. Thi instrument has been pre - audited in the
manner required by the Local overnment Bu and Fiscal Control Act:
Financial Services Director's Signature: �& Date: 2 % (L-
-�icac . 6 I z-u
Approval by Board ❑
contract). Approval by
form and sufficiency:
Attorney's Signature
County Attorney
ever $90,000.00 for goods or services, $250,000.00 for construction, or any BOCC consultant
(All other contracts). This contract has been reviewed and approved by the Attorney as to legal
Date: Z
County Manager
This contract has been reviewed and is approved by the County Manager Y"ETRo❑.
This contract has been reviewed and is to be sub ed for BOCC o sideration Yes❑Naff.
Manager's Signature: Date: _ 12/
Clerk to the Board
Approved by BOCC on the _ day of , 20 . Submitted for Chair signature on the _ day of , 20
Clerk's Signature:
Revised April 2010
Date: