HomeMy WebLinkAboutR 2013-429 AMS - Gonzalez Painters for Carpentry/Paint Work at 113 May Street Hillsborough DSS $5,250 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: Gonzalez Painters *&contractors Party/Vendor Contact Person: Florencio Gonzalez Contact Phone: 919-477-
6058 Party/Vendor Address: 3518 Guess Road City Durham State:NC Zip: 27705 Department:Asset Management Services Amount:
$5,250.00 Purpose: Crpenta/Paint Work at 113 May Streeet Hillsborough NC(DSS/Hillsborough Commons Budget Code(s):
10240320-570000 Vendor#61921 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one)
New® Renewal❑ Amendment ❑ Effective Date October 14,2013 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 Signature: ��— Date: /v L(r3
IT ire or
(Applicable only to hardware/software purchases or related services is contract has been reviewed and approved by the Information
Technology Director as to technical content and information tec to specifications:
IT Director's Signature: Date:
Risk Management
Include the following coverages: ❑ CGL; E] 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:
Risk Manager's Signature: an_.� Dater
bl4
Financial Services
This Contract is conditioned pon appropriation by the Board of Commissioners Yes❑NoE( A budget amendment is necessary
before approval Yes❑No M. 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: �� .J Date: 1 1I r
13
rl County Attorney
Approva (Contracts $90,000.00 more for goods or services, $2 more for construction, or any BOCC
consultant contract). Approva nagerost other contr and above). Department Director approval only❑ (Under
$1,000). This contract has been r viewed the Attorney as to legal form and sufficiency:
Attorney's Signature e: �
County Manager
This contract has been reviewed and is appro d by the County Manager Yes[ No❑.
This contract has been reviewe d i r ture y he C Y ❑No❑.
Manager's Signature: ____ Date: 3
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