HomeMy WebLinkAbout2012-241 S Mgr - Historical Foundation of Hillsborough & Orange Co $4,000 A
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: Historical Foundation of Hillsborough&Orange County Party/Vendor Contact Person: Brandie Fields Contact
Phone: (919)732-2201 Party/Vendor Address:201 N. Churton Street City Hillsborough State:NC Zip:27278 Department: Outside
Agency Amount: $4,000 Purpose: Outside Agency Budget Code(s): 10519550-710007 Vendor#3957 (N/A if new vendor) Vendor
is a BOCC consultant? Yes n No Contract Type: (Check one)New Renewal El Amendment El Effective Date 07/01/2012
Approved by Board Yes 2 No Agenda Date: 06/19/2012 Title of Contract: 2012-13 Outside Agency Performance Agreement
If this is a Grant Agreement, pre-application has bee •13,g o ed by the Board of Commissioners Yes0 Non. If submitted for bid were
bids/RFPs received Yes 0 Non Bid/RFP numeer Tiis contract has been reviewed and approved by the Department Director as to
technical content: I
,,,,,iffill ■
Department Director's Signature: AWM1b.. c) C Jr Date: 7 ---i —I 2._
S
I .'rector
(Applicable only to hardware/software purchases or related se s contract has been reviewed and approved by the Information
Technology Director as to technical content and information tec nology specifications:
IT Director's Signature: Date: _
Risk M,nagement
Include the following coverages: ErCGL; E(Auto; WC; IE Professional; 0 Property; n OR No Insurance Required 0. Hold
If
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: Uelevil V- I. 1A1---. Date: 7(1 4 (2_
Financial Services
This Contract is conditioned pon appropriation by the Board of Commissioners YespNo517 A budget amendment is necessary
before approval Yesp 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 Budge and Fiscal Control Act:
Financial Services Director's Signature: 01-JCL-- Date:
County Attorney
Approval by Board Tgl (Contracts over $90,000.00 for goods or services, $250,000.00 for construction, or any BOCC consultant
contract). Approval by Manager E (All other contracts). This contract has been reviewed and approved by the Attorney as to legal
form and sufficiency:
4 , ) 1\131
Attorney's Signature Date: 13--
County Manager
This contract has been reviewed and is approved by the County Manager Yejon.
This contract has been reviewed and is to be submitted for BOCC consideration Yesjalop.
Manager's Signature: /t-f-ed0 Date: -7 - 1 -/
Clerk to the Board
Approved by BOCC on the day of , i A . ,.ubmitted for C s'g ature on the da of ,20 .
Clerk's Signature: i i I Date: 9 2■'
4
Revised April 2010