HomeMy WebLinkAboutR 2014-150 AMS - Lomax Construction - Change Order #1 Carpet in lieu of VCT additional de-construction scope 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: Lomax Construction Company,Inc. Party/Vendor Contact Person: Rich Taylor Contact Phone: 336-992-7000,
x101 Party/Vendor Address: PO Box 35169 City Greensboro State:NC Zip: 27425 Department: AMS Amount: $5,331.00 Purpose:
Proposed Chanpe Order#1-Carpet in lieu of VCT;additional de-construction scope Budget Code(s): 61370035-880000-10028 Vendor
#62290 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one)New ❑ Renewal ❑
Amendment ® Effective Date 1/15/14 Approved by Board Yes®No❑ Agenda Date: 12/10/13 Title of Contract: Whitted
Meeting Room
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 1218This contract has been reviewed and approved by the Department Director as to
technical content:
Department Director's Signature: f! Date:
IT Director
(Applicable only to hardware/software purchases or related servic )This contract has been reviewed and approved by the Information
Technology Director as to technical content and information ch logy 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 E]. With incorporation of Insurance provisions as sho
by the Risk Manager: 8
Risk Manager's Signature: Date: cluz 9 z
Financial Services Q
This Contract is conditioned upon appropriation by the Board of Commissioners Yes❑No Vd. Abu
before approval Yes❑ NoF#j. If budget amendment is necessary, please attach to this form. This instrument has been pre-audited in the
manner required by the Local Government Bud Get_and•Fiscal Control Act:
Financial Services Director's Signature: A Ax-, Date: 2-12111y
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„a(Most other contracts $1,000 and above). Department Director approval only ❑ (Under
$1,000). This contract has been viewer nd a proved by the Attorney as to legal form and sufficiency:
•/Z�4
Attorney's Signature Date:
County Manager
This contract has been reviewed aVisa ro by the Co my Manager Yes o❑.This contract has been reviewed si ture b t Ch 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