HomeMy WebLinkAbout2012-370 S Solid Waste - Hudson Well Company Inc Water Well drilling and commissioning $5,576 lea— S7Q
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: Hudson Well Company Party/Vendor Contact Person: Paul Weller Contact Phone:919-417-6813
Party/Vendor Address:PO Box 05 City Rou eg, mont State:NC Zip:27572 Department: Solid Waste Amount: $5,576.00 Purpose:
Water well drilling and commissioning Budget Code(s): 5035 3030 880000 Vendor#49654 (N/A if new vendor) Vendor is a BOCC
consultant? Yes❑No® Contract Type: (Check one)New® Renewal❑ Amendment ❑ Effective Date 10/1/2012 Approved by
Board Yes❑No® Agenda Date: Title of Contract:
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:
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 techn ogy specifications:
IT Director's Signature: Date:
Ri k"Manaeement
Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required E� 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:�� V/ Date:
Financial Services
This Contract is conditioned ypon appropriation by the Board of Commissioners Yes❑No[ A budget amendment is necessary
before approval YesE:]NoM. 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:
Financial Services Director's Signature: l,(4-{ ln..�� ,t/h. Date: 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[9 (Most other contracts$1,000 and above). Department Director approval only❑(Under
$1,000). This contract has be eviewed and approved by the Attorney as to legal form and sufficiency:
Attorney's Signature Date: Vvihk.
County Manager
This contract has been reviewed and is approved by the County Manager Yes`No❑.
This contract has been reviewed and is for signature by the Cjrair Yes❑No[3-
Manager's Signature: Date:
Clerk to the Board
Approved by BOCC on the_day of 20 . Submitted for Chair signature on the_day of 120
Clerk's Signature: Date:
Revised March 2012