HomeMy WebLinkAbout2012-375 S AMS - 5th Wall Roof Replacement Battle Courtroom $10,100 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: 5h Wall Party/Vendor Contact Person: jeffirgy Snadv Contact Phone:919-616-4715 Party/Vendor Address:9601
BaileyLvick Rd City Raleigh State:NC Zip:27615 Department:AMS Amount:$10,100 Purpose:Roof Replacement Design Srvcs-
Battle Courtoorn Budget Code(s):61370035-870000-30002 Vendor#58369 (N/A if new vendor) Vendor is a BOCC consultant?
Yes F-1 No❑ Contract Type: (Check one)New❑ Renewal❑ Amendment ❑ Effective Date— 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 Commissio rs ❑No❑. If submitted for bid were
bids/RFPs received Yes❑No❑ Bid/RFP number This contrac as e d ap r ve by the Department Director as to
technical content:
Department Director's Signature: Date: /llf/o,//2---
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 specifications:
IT Director's Signature: Date:
'11i is k MaIjazement
Include the following coverages: C4 CGL; &Auto; E�WC; 9Professional; ❑ Property; OR No Insurance Required ❑. Hold
Contract pending receipt of Certificate of Insurance FT With incorporation of Insurance provisions as shown,this contract is approved
by the Risk Manager:
2
Risk Manager's Signature: Date: 1) z__
io1z,
Financial Services
This Contract is conditioned pon appropriation by the Board of Commissioners Yes❑Nog/ A budget amendment is necessary
before approval Yes❑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 Budget and Fiscal Contr I Act:
U _V
Financial Services Director's Signature: _�V a v Date:
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❑(under
$1,000). This contract has been reviewed and approved by the Attorney as to legal form and sufficiency:
Attorney's Signature �a4� Date:
County Manager
This contract has been reviewed and is approved by the County Manager YesErNoEl
This contract has been reviewed and is for sign Yes❑No,�
Manager's Signature: Date:- /-d-
&1erk 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