HomeMy WebLinkAbout2012-088 S Contract Child Support - Longent $18,649.70ORANGE 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 Iegal review should
be completed through the legal review process prior to being routed for signature.
Department
Party/Vendor Name: Lone Party /Vendor Contact Person: Jeff St. Clair Contact Phone: 336- 255 -1514 Party/Vendor Address: 7517
Precision Drive City Raleigh State: NC Zip: 27617 Department:« it pport Enforcement Amount: $18w 64970 Purpose: Supply and
installation of equipment for cell phone coverage enhancement Budget Code(s): Vendor * 2 ` /A if new vendor] V—Y�� en5or
is a BOCC consu tan ."Yes Duo®.. Contract Type: (Check one) New ® Renewal ❑ Amen ment ❑ Effective Date
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:
Department Director's Signature: Date:
IT Director
(Applicable only to hardware /softr€are 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:
Risk Management
Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required [ Hold
Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as shown, this contract is approved
by the Risk Manager:
Risk Manager's Signature: Date: 4 • t J • (7i
t
Financial Services
This Contract is conditioned upon appropriation by the Board of Commissioners Yes❑NX. 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 Loea Government Budget and Fiscal Control Act:
Financial Services Director's Signature: Date:
CountV Attorne
Approval by Board ❑ (Contracts $90,000.00 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: ..2
i
Attorney's Signature_ ` Date: 711 0
k Count Mana er
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 ❑No®;"
Manager's Signature:
Approved by BOCC on the day of
Cleric's Signature:
}devised November 2011
Date: 1'
Cleric to the Board
Submitted for Chair signature on t ay o _, 20
Date: