HomeMy WebLinkAboutR 2013-144 EMS - Orange County Speedway Management to provide EMS coverage at OC Speedway events $100 PER HR D)-3--L�
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: Orange County Speedway Management,LLC Party/Vendor Contact Person: Beverly Liles Contact Phone: 336-
364-1222 Party/Vendor Address:9740 NC Hiizhwqy 57 City Rougemon State:NC Zip:27572 Department: Orange County
Emergency Services Amount: $100/hour,variable hours Purpose:To provide EMS coverage at OC Speedway events Budget Code(s):
Vendor# (N/A if new vendor) Vendor is a BOCC consultant? Yes❑NoE Contract Type: (Check one)New❑
Renewal S Amendment r_1 Effective Date Approved by Board Yes❑NoE 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 c act has been reviewed and approved by the Department Director as to
technical content:
Department Director's Signature 4(� Date:
7 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:
Risk Management
Include the following coverages: D/CGL; []Auto; a WC; ❑ Professional; ❑ Property; OR No Insurance Required El. 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: Date:
q 13
Financial Services
This Contract is conditioned qj4bn appropriation by the Board of Commissioners YesE]NoE3/ A budget amendment is necessary
before approval Yes❑No[R.' 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: ('Ya,6"_, Date: 3
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). Approva Ay Manager Ix(Most other contracts$1,000 and above). Department Director approval only E](Under
$1,000). This contract has iew approved by the Attorney as to legal form and suffici ncy:
Attorney's Signature Date:
County Manager
This contract has been reviewed and is approved by the County Manager Yes 00.
This contract has been reviewed and is for signature by the C YesMNoa-7.-,
Manager's Signature: Date:-,5 —2,1
k 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