HomeMy WebLinkAbout2012-409 S EMS - Federal Engineering Inc for needs assessment $49,830 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.
V FW_Z i1Q') `7EF�-_) Department
Party/Vendor Name: Federal Engineering,Inc. Party/Vendor Contact Person: Larry Keller Contact Phone:703-359-8 aftyNendor
Address: 10600 Arrowhead Drive City Fair State:VA Zip:22030 Department:Emergency Services Amount- - R30 3e:
needs assessment Budget Code(s): Vendor#na (N/A if new vendor) Vendor is a BOCC consultant? Yi s El Contract
Type: (Check one)New M Renewal❑ Amendment ❑ Effective Date Approved by Board YesF_1 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 YesE No❑ Bid/RFP number 5188This contract has been reviewed and approved by the Department Director as to
technical content: GA 7-1
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Department Director's Signature: Date: it
..............
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:
R'sk�t
,_jisk Ma Professional;s ic Hold
Include the following coverages. Q`CGL; E� Auto; WC; , Professional; R Property; OR No Insurance Required F
Contract pending receipt of Certificate of Insurance Fl. With incorporation of Insurance provisions as shown,this contract is approved
by the Risk Manager: I Risk Manager's Signature: A. 41,1_ Date:
t 1,Z:71 IL-_
Financial Services
This Contract is conditioned on appropriation by the Board of Commissioners YesF�NoEg/ A budget amendment is necessary
before approval YesF�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 Control Act:
P ,
Financial Services Director's Signature: L/t P4 j__ /) Date:
County Attorney
Approval by Board ❑ (Contracts $90,000[(Most or more for goods or services, $250,000.00 or more for construction, or any BOCC
consultant contract). Approval by Manager other contracts$1,000 and above). Department Director approval only❑(Under
$1,000). This contract has:be:eMrAeviewe d approved by the Attorney as to legal form and sufficiency:
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Attorney's Signature Date:
V
County Manner
This contract has been reviewed and is approved by the Cou ty Manager YcsXNoF_1.
This contract has been reviewed and is for signs WT�y t YesFjN
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