HomeMy WebLinkAboutR 2013-015 Library - State Library of NC for LSTA Grant award topo work on the Strategic Planning Grant $15,010 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: State Library of NC Party/Vendor Contact Person: Raye Oldham Contact Phone:919-807-7400 Party/Vendor
Address: 109 East Jones Street City Raleigh State:NC Zip:27601 Department: Library Amount: $15,0 10 Purpose: LSTA Grant
award to work on the Strategic Planning Grant Budget Code(s): Vendor# (N/A if new vendor) Vendor is a BOCC
consultant? Yes❑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 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 Si ature: e:
IT Director
(Applicable only to hardware/softwa purchases or related services)This contract has been reviewed and approved by the Information
Technology Director as to technical content a formation technology specifications: l
IT Director's Signature: Date:
Risk Management
Include the following coverages: ❑ C L; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required [� Hold
Contract pending receipt of Certificate o Insurance ❑. With incorporation of Insurance provisions as shown,this contract is approved
by the Risk Manager:
Risk Manager's Signature: �'"` . Ah Date: 12 Z4 1,7—
Financial Services
This Contract is conditioned on appropriation by the Board of Commissioners Yes❑NoEr 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 Co trol Act-
Financial Services Director's Signature: ob" ✓9' a� Date: 17, �--
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 evi d and approved by the Attorney as to legal form and sufficTs ,c
Attorney's Signature Date:
County Manager
This contract has been reviewed and is approved by the County Manager Yes[]No❑.
This contract has been reviewed and is for sign y ,chair Yes❑No�
F /
Manager's Signature: Date: ( �- qy
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