HomeMy WebLinkAbout2012-347 S DEAPR - NC Dept of Ag & Forest Service $78,170 51-4
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: NC Department of Agriculture and consumer Services-NC Forest Service Party/Vendor Contact Person: John
Howard,District forester Contact Phone: 919-732-8105 Party/Vendor Address: 3314 NC 86 South City Hillsborough State:NC Zip:
27278 Department:DEAPR Amount: $78,170.00 Purpose:Annual Forest Service Contract Budget Code(s): 10519550-720011 Vendor
#25374 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑NoE Contract Type: (Check one)New❑ Renewal E
Amendment ❑ Effective Date Approved by Board YesZ No❑ Agenda Date:4.
LO-12 Title of Contract:Agreement for the
Protection,Development and Improvement of Forest Land in Orange County,NC
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:
A 23 2
IT Director
(Applicable only to hardware/software purchases or related services)This contract has been reviewed and approved by the Information
Tee ology Dire for as to technical content and information technology specifications:
IT DDXiirecls Signature: Date:
Risk Management
Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; F-1 Property; Of', No Insurance Required Yr Hold
_'d
Contract pending receipt of Certificate of Insurance L�N With incorporation of Insurance provisions as shown, this contract is approved
by th Risk nager:
t IZ
Risk an er's Signature:A041z"I Date:
/ _Ll� , I-
FUCS
Financial Services
This Contract is conditioned Xpon appropriation by the Board of Commissioners YesE]NoE/ A budget amendment is necessary
before approval Yes❑No[g. If budget amendment is necessary,please attach to this form. This instrument has been pre-audited in the
manner required by the Local Government Budget and Fiscal Control Act: 1
'716
Financial Services Director's Signature: Date: 4 f-V t, Z.
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❑ (Most other contracts$1,000 and above). Department Director approval only F-1(Under
$1,000). This contract has been reviewed and a ved by the Attorney as to legal form and sufficiency:
A t t o r\nCV1S_Signature Date:
County Manner
This contract has been reviewed and is app Dyed by the C unty Manager Y No❑.
This contract has been reviewed and is fo s n b t e air Ye40'No[:1.
,a
M4<sSignature: Date-
� Clerk to the Board
Approved by BOCC on the_day of 20—. Submitted for Chair signature on the day of 20
Clerk's Signature: Date:—
Revised March 2012