HomeMy WebLinkAboutR 2014-142 ES - Cedar Grove Fire Department for Fire Protection Agreement 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 con view. Contracts for legal review should
tract for BOCC approval. Contracts for
BOCC approval must be submitted through,and complete,the routing process prior to agenda re
be completed through the legal review process prior to being routed for signature.
Department
Party/Vendor Name: Cedar Grove Fire De artment Party/Vendor Contact Person: Jeff Borland Contact Phone:919-619-2566
Party/Vendor Address: 720 Hawkins Road City Cedar Grove State:NC Zip:27231 Department:Emergency Services Amount:
Purpose:Fire Protection Agreemen t Budget Code(s): Vendor#
Yes[I No® Contract Type:(Check one)New El Renewal (N/A if new vendor) Vendor is a BOCC consultant?
® Amendment ❑ Effective Date Approved by Board Yes®
No❑ Agenda Date: 11/19/2013 Title of Contract:Fire Protection and EmergengE Services Agreement
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 nu er Thi ontract has been reviewed and approved by the Department Director as to
technical content:
Ct�lellt DireCtor's Signature; Date: 1'Y
DGpa
IF Director
(Applicahle 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: (S D 9, ( n fV7 T
Risk Manager's Signature: � �� � — Date:
/� FEB 11 203
211
Financial Services
This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No� A b t amendment is necessarl
before approval Yes❑NoM.If budget amendment is necessary,please attach to this form. This instrumen as ee
manner required by the Local Government Budget and Fiscal Control Act:
Financial Services Director's Signature: • Date:
—z11 L
County Attorney
Approval by Board 2-1('C'ontracts $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 reviewed and approved by the Attorney as to legal form and sufficiency:
Attorney's Signature
County Manager
This contract has been reviewed is pro by the Coun Manager Yes No❑.
This contract has been reviewe d is r s'g at th air s❑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