HomeMy WebLinkAboutR 2013-067 Housing - Habitat for Humanity for Y 2012 Home Program $75,000 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: Habitat for Humanity Party/Vendor Contact Person: Susan Levy Contact Phone:919-932-7077 Party/Vendor
Address: 88 Vilcom Center Drive City Chapel Hill State:NC Zip:27514 Department:Housing/Human Rights and Community
Development Amount:$75,000 Purpose:FY 2012 HOME Program Budget Code(s):32473005 Vendor 4 (N/A if new vendor)
Vendor is a BOCC consultant? Yes❑Noo Contract Type:(Check one)New❑ Renewal❑ Amendment E Effective Date
01/02/13 Approved by Board YesZ No❑ Agenda Date:05/01/2012 Title of Contract:Development Agreement Amendment
If this is a Grant Agreement,pre-application has been approved by the Board of Commissioners Yes❑Noo. 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 t-�� Date:
IT *r ctor
(Applicable only to hardwarelsoftware purchases or related service 4TIhiscontract has been reviewed and approved by the Information
Technology Director as to technical content and information techn to specifications:
IT Director's Signature: Date:
Risk Ma dement
Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; El^esional; ❑ Property; F-1 OR No Insurance Required V. Hold
orno
Contract pending receipt of Certificate of Insurance E]. With in orpo tion of Insurance provisions as shown,this contract is approved
by the Risk Manager:
Risk Manager's Signature: A I A fv Date:
*car-- Z--o I I=,,
Financial Services
This Contract is conditioned 9pon appropriation by the Board of Commissioners Yes❑Nod A budget amendment is necessary
before approval Yes❑No[g. 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: A A, Date: 13
County Attorney
Approval by Board ❑ (Contracts over $90,000.00 for goods or services, $250,000.00 for construction, or any BOCC consultant
contract). Approval by Manager (All other contracts). This contract has been reviewed and approved by the Attorney as to legal
form and sufficiency:
Attorney's Signature Date: 3
County Manner
This contract has been reviewed and is approved by the County Mapazer YesE?etO'❑.
This contract has been reviewed and is to be sub * d f BO sideration Yes[:]N6[1----
Manager's Signature: t= Date:
Cleryto the Board
Approved by BOCC on the day of 120 . Submitted for Chair signature on the_day of 20
Clerk's Signature: Date:
Revised April 2010