HomeMy WebLinkAboutR 2014-254 AMS - Advanced Sealcoating for paint and stencil parking spaces at County bldgs. -E5 y
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: Advanced Sealcoating Party/Vendor Contact Person: Dan Stark Contact Phone:919-844-2257 Party/Vendor
Address: 8804 Erinsbrook Drive City Ralei State:NC Zip:27617 Department:Asset Management Services Amount: $6,800
Purpose:Paint and stencil parking spaces at Eno River Parking Deck West Campus Library,West Campus Offices and Gateway Budget
Code(s): 10240120-570525 Vendor#59959 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type:
(Check one)New® Renewal❑ Amendment ❑ Effective Date May 20,2014 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❑Non Bid/RFP number This contract has been reviewed and approved by the Department Director as to
technical content:
Department Director's Signature: C "�� Date: 5 23-t
I it for
(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 tec olo specifications:
IT Director's Signature: Date:
Risk Manaeement
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 sho s&Qn is-W
by the Risk Manager: O U
Risk Manager's Signature: (�-e�- '�"' v Date: z MAY 27 2014
Financial Services By
This Contract is conditioneddypon appropriation by the Board of Commissioners Yes❑Now A bu
before approval Yes❑NoIf 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: � � 1 q
Financial Services Director's Signature:
l�Wl�l�i GV ,U" JU AtAj Date: 5I -t
County Attorney
Approval by Board ❑ (Contracts $90,000.00 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 a ved by the Attorney as to legal form and sufficiency:
Attorney's Signature Date: ��
County ManaEer�
This contract has been revieZ!g y the County Manager Yes o❑.
This contract has been reviere Yh Yes❑No❑.
Manager's Signature: Date: Z/4 J� 4
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