HomeMy WebLinkAboutR 2014-210 AMS - Legacy Research Associates - Change Order #1, C & A monitoring geothermal well trenching P4- zD
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: Legacy Research Associates Party/Vendor Contact Person: Deborah Joy Contact Phone: 919-682-2408
Party/Vendor Address: 125 West Woodridge Drive City Durham State:NC Zip:27707 Department: Asset Management Amount:Not
to exceed$10,000.00 Purpose: Change Order#1 to Contract 42013-124: C&A Monitorine the Geortherman Well Trenching at t Old
Courthouse,Jail and the Market House/Riverwalk Park Budget Code(s): 10240320-630000 Vendor#43430 (N/A if new vendor)
Vendor is a BOCC consultant? Yes❑No® Contract Type: (Check one)New❑ Renewal❑ Amendment ® Effective Date March
2014 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: f
Department Director's Signature: Date:
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: Date:
Risk Management
Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Inst rance Re uired . Hold
Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as sho _ i cTjft R Irr�
by the Risk Manager:
Risk Manager's Signature: Z21" > 0 Date: APR 3 0 2014
Financial Services By
This Contract is conditioned�tpon appropriation by the Board of Commissioners Yes❑No[ A budget amendment is necessary
before approval Yes❑NoM. 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• t
Financial Services Director's Signature: �' 'o "_— Date:
515
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 01 other contracts$1,000 and above). Department Director approval only❑ (Under
$1,000). This contract has been rev' wePpproved by the Attorney as to legal form and sufficiency:
Attorney's Signature Date:
County Manager
This contract has been reviewed and is approved the County Manager Yes No❑.
This contract has been reviewed an i for r by ha* s❑ ❑.
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