HomeMy WebLinkAbout2012-060 S Housing - Habitat for Humanity for Orange Co $150,000ORANGE 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: Habitat for ani of Orange County, NC Inc. Party/Vendor Contact Person: Susan Levy Contact Phone: 919-
932 -7077 Party/Vendor Address: 88 Vilcom Center rive, urte City Chapel Hill State: NC Zip: 27514 Department:
Housing/Human Rights and Communi!y Development Amount: $150,000 Purpose: HOME Program - Second Mortgage Assistance
Budget Code(s): 32473020 783010 47310 Vendor # (N /A if new vendor) Vendor is a BOCC consultant? Yes No
Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 02/10/2012 Approved by Board Yes❑ No❑
Agenda Date: 05/03/2011 Title of Contract: FY 2011 - 2012 HOME Program
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:
IT Director
(Applicable only to hardware /software purchases or related services) 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: �'
' r p�' -�j (itral/It -4& L�YI
Risk Management No our ur I � UC (�lYl'� OA441?
Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property;0 o Insurance Required ❑. Hold
Contract pending receipt of Certificate of Insurance El. With incorporation of Insurance ovisions as shown, this contract is approved
by the Risk Manager: fW
Risk Manager's Signature: Date: 0 • % • /Z-"
Ape 1 3(0112
Financial Services
This Contract is conditioned upon appropriation by the Board of Commissioners Yes ❑NoI. A budget amendment is necessary
before approval Yes❑ Not. If budget amendment is necessary, please attach to this form. This instrument has been pre- audited in the
manner required by the Local Government Budget and Fiscal �Control Act:
Financial Services Director's Signature: U ""... ✓� /YY Date: 2
Countv Attorne
Approval by Board ❑ (Contracts over $90,000.00 for goods or services, $250,000.00 for construction, or any BOCC consultant
contract). Approval by M f�l er All other contracts). This contract has been reviewed and approved by the Attorney as to legal
form and sufficiency: n
Attorney's Signature \ Date: x>17• --
Countv Manager
This contract has been reviewed and is approved by the County Manager Yes ❑.
This contract has been reviewed and is to be su ed for BOCC consideration Yes❑N,oQ-
Manager's Signature: Date: 3 z r
l
t to the Board
Approved by BOCC on the _ day of , 2 Submitted for Chair signature on t _ day of , 20
Clerk's Signature: Date: ]?/) Z,L\�
Revised April 2010