HomeMy WebLinkAbout2012-349 S AMS - JF Wilkerson Contracting Co for Force Main Adj Sper State Approval of Outfall Design $24,507.94 549
CS Vii,),-u> , 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 Corder specified above. If the Manager
determines the contract is not appropriate for Manager approval the Manager shall submit the contrict 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: J.F.Wilkerson Contracting Company Party/Vendor Contact Person: Joseph Wilkerson Contact Phone: 9 9-467-
1829 Party/Vendor Address: 10710 Chapel Hill Road City Morrisville State:NC Zip:27560 Department:AMS Amount: 2 507.9
Purpose: Change Order#I-Force Main Adjustment per State Approval of Outfall Design Budget Code(s):61370035-880000-30
Vendor#55607 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract T}pe:(Check one)New❑ Rene
❑ Amendment ® Effective Date 8/21/2012 Approved by Board Yes®No❑ Agenda Dab 8/23/2011 Title of Contract:
Sanitary Sewer Improvements for Buckhorn Area North of I-85&Central Efland
If this is a Grant Agreement,pre-application has been approved by e Bo rd o o issi rs Y(,-s®No❑. If submitted for bid were
bids/RFPs received Yes❑No❑ Bid/RFP number c ac n re a approv d by a Department Director as to
technical content: �� i
Department Director's S nature: Date:
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 ecifications:
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 E]. With incorporation of Insurance provisions as shown,this contract is approved
by the Risk Manager: / n
Risk Manager's Signature: �` -� .CJ Date: � ZF /2_
Financial Services
This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No[d A budget amendment is necessary
before approval Yes[:]No[g.If budget amendment is necessary,please attach to this form. This :nstrument has been pre-audited in the
manner required by the Local Government Budget®and -Fiscal Control Act:
Financial Services Director's Signature: Caw "4L— Date: Z Z
County Attorney
Approval by Board ❑ (Contracts $901000.00 r more for goods or services, $250,000.00 or more for construction, or any BOCC
consultant contract). Approval by Managerl, (Most other contracts$1,000 and above). Department Director approval only ❑ (Under
$1,000). This contract has be n re iewed proved by the Attorney as to legal form and sufficiency:
Attorney's Signature � Date:
County Manager
This contract has been reviewed and is approved by the CounW Manager Ywa-1470❑.
This contract has been reviewed and is r ature
hv the C air Yes❑Nom
Manager's Signature: ��-- Date: ' v
Clerk to the Board
Approved by BOCC on the_day of-77,:0 Submitted for Chair signature on the_day of ,20
Clerk's Signature: Date:
Revised March 2012