HomeMy WebLinkAboutR 2013-297 Animal Services - Lisa Duff for Provide Microchipping Services for clinic $126 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: Lisa Duff Party/Vendor Contact Person: Lisa Duff Contact Phone: 919-369-4890 Party/Vendor Address:2393
Moncure Pittsboro Rd City Pittsboro State:NC Zip:27559 Department:ANIMAL SERVICES Amount:not to exceed$126.00
Purpose:Provide Microchipping Services for clinic Budget Code(s): 10215020 629003 Vendor#62008 (N/A if new vendor) Vendor
is a BOCC consultant? Yes❑No® Contract Type:(Check one)New® Renewal❑ Amendment ❑ Effective Date 7/18/2013
Approved by Board Yes❑No® Agenda Date:NA Title of Contract: Contract Under$1,000 Lisa Duff-Microchipping Services for
Clinic
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: +q
Department Director's Signatu Date?2•1 a
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: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; ❑ OR No Insurance Required Hold
Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as shown,this contract is approved
by the Risk Manager: /y i
Risk Manager's Signature: �w��' �' Date:
Financial Services
This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No 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 Budge.tand Fiscal Control A p 2
Financial Services Director's Signature: �-t-/ Date: t1 2' t J
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 ha�n reviewed and approved by the Attorney as to legal
form and sufficiency: AA �,frvtpl,f �1
Attorney's Signature Date: Z
County Manager
This contract has been reviewed and is approved by the County Manager Yes[]Nor-1.
This contract has been reviewed and is to be submitted for BOCC consideration Yes❑No❑.
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 April 2010