HomeMy WebLinkAbout2012-187 S DEAPR - Darroll Andrew Brown for Fairview Tennis $409.50 a0/a /67
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: Darroll Andrew Brown Party/Vendor Contact Person: same Contact Phone:919 740-2693 Party/Vendor Address:
113 Tuscarora Dr. City Hillsborough State:NC Zip:27278 Department:DEAPR Amount:$409.50 Purpose:Fairview Tennis Budget
Code(s):Woryendor# (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type:(Check one)New
® Renei61 11111 Amendment ❑ Effective Date July 1,2012 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
tgclinical content:
A CI)
Department Director's Signature: �/ " '� Date: Col 2.l Ji 2
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:
Director's Signature: Date:
Risk Management
include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No insurance Required E " Hold
Contract pending receipt of Certificate of Insurance 0. With incorporation of Insurance provisions as shown,this contract is approved
by the Risk Manager:
Risk Manager's Signature:�bJI ' t Date: (.
'L ' v
/ea' td- W02-/f-2al�
Financial Services
This Contract is condition d 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, his instrument has been pre-audited in the
manner required by the Local Government Budget and Fiscal Control Act:
"Financial Services Director's Signature: 4 n Date: ! 3 ) 12-
County Attorney
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 0(Most other contracts$1,000 and above). Department Director approval only❑(Under
$1,000). This contract has beer - viewed and approved by the Attorney as to legal form and sufficiency:
Attorney's Signature Date: 7/$'1i
County Manager
This contract has been reviewed and is approved by the County Manager Y.esii rto❑.
This contract has been reviewed and is for signature by the Chair Yes❑N
it /1: 7.7_72_
� � Date:
Manager's Signature: .
Clerk to the Board
Approved by BOCC on the_day of ,20 . Submitted for Chair signature on the_day of ,20 .
"gerk's Signature: Date:
Revised March 2012