HomeMy WebLinkAboutR 2013-511 Planning - Town of Chapel Hill for Building Inspector Assistance $50 per Hr X013- .91
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: Town of Chapel Hill Party/Vendor Contact Person: Contact Phone:919-968-2743 Party/Vendor Address:
405 Martin Luther King,Jr.,Blvd. City Chapel Hill State:NC Zip:27514 Department: Planning&Inspections Amount: $50.00 pe r
hour Purpose:Building Inspector Assistance Budget Code(s):Building Inspections Revenue Account 10621003-422000 Vendor#64
(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❑Non. If submitted for bid were
bids/RFPs received Yes❑Non Bid/RFP number This contract has been reviewed and approved by the Department Director as to
technical content:
Department Director's Signatur . Date:
IT rector
(Applicable only to hardware/software purchases or related s rvi s)This contract has been reviewed and approved by the Information
Technology Director as to technical content and information to ology 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: _a-1'1419
Risk Manager's Signature: Date:
Financial Services
This Contract is condi oned upon appropriation by the Board of Commissioners YesdNo❑. 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 Bjlet and Fiscal Control ct.Financial Services Director's Si 1;nature: �^" �d"� Date:
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 14 (Most other contracts$1,000 and above). Department Director approval only❑ (Under
$1,000). This contract has been reviewed and approved by the Attorney as to legal form and sufficiency:
Attorney's Signature Date:
County Manager
This contract has been reviewed and is ap ed by the County Manager Yes io❑.
This contract has been reviewe s f S arr by Ch# 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 March 2012