HomeMy WebLinkAbout2012-138 S Housing - Habitat for Humanity 2011-HOME PROGRAM $75,000 0.01Z- l $ ORANGE COUNTY—CONTRACT CONTROL SHEET
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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 Humanity PartyNendor Contact Person: Susan Levy Contact Phone:919-932-7077 PartyNendor
Address: 88 Vilcom Center Drive City Chapel Hill State:NC Zip:27514 Department:Housing/Human Rights and Community
Development Amount:$75,000 Purpose:FY 2011 HOME Program Budget Code(s):32473005 Vendor# (N/A if new vendor)
Vendor is a BOCC consultant? Yes❑No Contract Type: (Check one)New® Renewal❑ Amendment ® Effective Date
04/24/2012 Approved by Board Yes No❑ Agenda Date:05/03/2011 Title of Contract:Development Agreement
If this is a Grant Agreement,pre-application has been approved by the Board of Commissioners Yes❑Non. 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: /b/,Department Director's Signat re: 2 'C/ Date:
IT I're. or
(Applicable only to hardware/software purchases or related services!'
ervices is contract has been reviewed and approved by the Information
Technology Director as to technical content and information techn s o l specifications:
IT Director's Signature: Date:
Risk n ement
Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ fessional; El Prooppe y; ❑ OR No Insurance Required ❑. Hold
Contract pending receipt of Certificate of Insurance ❑. With i orpo tion of Insurance provisions as shown,this contract is approved
by the Risk Manager:
Risk Manager's Signature: Date:
Financial Services
This Contract is conditioned upon appropriation by the Board of Commissioners Yes❑No A budget amendment is necessary
before approval Yes❑NojJ. If budget amendment is necessary,please attach to this form. y s instrument has been pre-audited in the
manner required by the Local Government Budget nand Fiscal Control Act:
Financial Services Director's Signature: 21 Date: C t L
County Attorney
Approval by Board ❑ (Contracts over $90,000.00 for goods or services, $250,000.00 for construction, or any BOCC consultant
contract). Approval by Mana: r ( ((A other contracts). This contract has been reviewed and approved by the Attorney as to legal
form and sufficiency:
Attorney's Signature I 41 Date: (a (S112--
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County Manager
This contract has been reviewed and is approved by the County Manager Ye o❑.
This contract has been reviewed and is to be submitted for :O consideration Yes❑Nota"
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Manager's Signature: Date: ��3 -/Z.---
Jerk to the Board
Approved by BOCC on the day of _ j 0 . Submitted for Chair signature on the day of ,20 .
Clerk's Signature: / y ,• • /— Date: /�g�Z
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Revised April 2010 / 62 6-- 1�6,6 ��%�� ,