HomeMy WebLinkAbout2012-358 S Planning - NCDPT NC CTP Administrative Grant $0 ORANGE COUNTY—CONTRACT CONTROL SHEET
Routing Order: (1)Department,(2)IT,(3)Risk Management,(4)Financial Services,(5)Attorney,(6)Manager,(7)Clerk
This Document shall accompany all contracts and shall be submitted for signature in the Routing Order specified above. If the Manager
determines the contract is not appropriate for Manager approval the Manager shall submit the contract for BOCC approval. Contracts for
BOCC approval must be submitted through,and complete,the routing process prior to agenda review. Contracts for legal review should
be completed through the legal review process prior to being routed for signature.
Department
Party/Vendor Name: NCDOT Party/Vendor Contact Person: Mr.Charlie C.Wright.Financial Manager Contact Phone: 919-707-4674
Party/Vendor Address: Transportation Building 1 S Wilmington St Room 524 City Raleigh State:NC Zip:27699 Department:
Planning&Inspections/OPT Amount:$R.00 Purpose:NC CTP Administrative Grant Budget Code(s): Vendor# (N/A if
new vendor) Vendor is a BOCC consultant? Yes❑Non Contract Type:(Check one)New❑ Renewal❑ Amendment ❑
Effective Date Approved by Board Yes®No❑ Agenda Date: 1/24/2012 Title of Contract:Nonurbanized Area Public
Transportation Grant Agreement for Public Body Organizations Community Transportation Program-Section 5311
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 Signatu
IT Director
(Applicable only to hardwarelsoftware purchases or related services)This contract has been reviewed and approved by the Information
Technology Director as to technical content and information technology specifications:
IT Director's Signature: Date:
Risk Management
Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Re uired- . Hold
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: A Date: �Z~
Financial Services
This Contract is conditioned u n appropriation by the Board of Commissioners Yes❑Nod A budget amendment is necessary
before approval Yes❑No�f 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 ct:
Financial Services Director's Signature: Date:
County Attorney
Approval by Boar (Contracts $90,000.00 or more for goads 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❑(Under
$1,000). This contract has been r view d approved by the Attorney as to legal form and sufficiency:
Attorney's Signature --•e Date:
County Manager
This contract has been reviewed and is approved by the County Manager Yesf�"No❑.
This contract has been reviewed and is for signatpre7& air YesERNo❑.
Manager's Signature: 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