HomeMy WebLinkAbout2012-074 NS Attorney - Health System Properties LLC $143,651.17 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: Health System Properties,LLC PartyNendor Contact Person: William L.Roper Contact Phone: (919)966-0692
PartyNendor Address: 101 Manning Drive,4th Floor, Wing E City Chapel Hill State:NC Zip: 27514 Department: County Attorney
Amount: $143,651.17 Purpose: Eastowne Parcel Tract 1 Budget Code(s): Vendor# (N/A if new vendor) Vendor is a
BOCC consultant? Yes❑No Contract Type: (Check one)New /1 Renewal❑ Amendment ❑ Effective Date January 6,2012
Approved by Board Yes❑No❑ 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
bids/RFPs received Yes❑No❑ Bid/RFP number This contract has been reviewed and approved by the Department Director as to
technical content:
I,
Department Director's Signature: Date: 37c7/-14.\--...
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: /1(x} Date:
Risk Management
Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required ❑. Hold
Contract pending receipt of Certificate of Insurance D. With incorporation of Insurance provisions as shown,this contract is approved
by the Risk Manager:
Risk Manager's Signature: n 14q Date:
Financial Services
This Contract is conditio upon appropriation by the Board of Commissioners Yes❑No[ A budget amendment is necessary
before approval Yes❑No . If budget amendment is necessary,please attach to this form. This instrument has been pre-audited in the
manner required by the Local Government Bud t and Fiscal Co trol Act:
Financial Services Director's Signature: ` Date:
County Attorney
Approval by Board ❑ (Contracts $90,000.00 o; more for goods or services, $250,000.00 or more for construction, or any BOCC
consultant contract). Approval by Manager 2(Most other contracts$1,000 and above). Department Director approval only❑ (Under
$1,000). This contract has bee?eviewed and approved by the Attorney as to legal form and sufficiency:
/
(0,4 Attorney's Signature � ` Date: a . `Q1/R-
County Manager
This contract has been reviewed and is approved by the County Manager Y No❑.
This contract has been reviewed and is for signs re byte hair Yes0No0.
1 i'L(__,
Manager's Signature: Date: 1`-
Jerk to the Board
Approved by BOCC on the day of ,20 _ i bmi r ed for Chair signature on the day of ,20 .
IClerk's Signature: / Date:42424
ttitww j A otei-vul 04tpie"..5
Revised March 2012