HomeMy WebLinkAboutR 2014-111 BOCC - Visser Project Management Consulting Services for BOCC retreat facilitation ---)p - llt
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. V
Department ,
Pa Nendor Name: Visser Proiect Management Consulting Services Party/Vendor Contact Person: Rod Visser Contact Phone: 919- '
rh' -J � g
929-9516 Party/Vendor Address: 104 Sturbridge Lane City Chapel Hill State:NC Zip:27516 Department:BOCC Amount:Not to
exceed$5000.00 Purpose:BOCC retreat facilitation Budget Code(s): Vendor# (N/A if new vendor) Vendor is a
BOCC consultant? Yes❑No® Contract Type:(Check one)New® Renewal❑ Amendment ❑ Effective Date December 1
Approved by Board Yes❑No[V Agenda Date: Title of Contract:
If this is a Grant Agreement,pre-Application has been approved by the Board of Commissioners Yes❑Nom. 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: / 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:1\� 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:
Risk Manager's Signature: Qlis— f--P Dater
Financial Services
This Contract is conditioned upon 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 Budget and Fiscal Control A A ct: r
Financial Services Directors Signature: 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® (Most other contracts$1,000 and above). Department Director approval only❑(Under
$1,000). This contract has been rev :wed ap ved by the Attorney as to legal form and sufficiency:
Attorney's Signature ---- Date:
County Manager
This contract has been reviewed and i ppr ved by the County Manager Yes No❑.
This contract has been review an fo s'gnatur y t a' es❑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