HomeMy WebLinkAboutR 2014-268 AMS - State Contracting for asphalt paving, milling, overlay 144 E. Margaret Ln 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: State Contracting Party/Vendor Contact Person: Deborah Todd Contact Phone:919-453-2755 Party/Vendor
Address:P.O.Box 1934 City Wake Forest State:NC Zip:27588 Department: Asset Management Services Amount: $56,280.00
Purpose:Asphalt Patine Milling and Overlay at 144 E.Margaret Lane,Hillsborough,NC 27278 Budget Code(s): 61370035-880000-
30018 Vendor#62513 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type:(Check one)New
Renewal ❑ Amendment ❑ Effective Date June 9,2014 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: 6. ?- 1 4
I rector
(Applicable only to hardware/software purchases or related se ry es)This contract has been reviewed and approved by the Information
Technology Director as to technical content and information t logy specifications:
IT Director's Signature: Date:
Risk Management
Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No In
Contract pending receipt of Certificate of Insurance E]. With incorporation of Insurance provisions as sho s n cis
by the Risk Manager:
/ JUN - 4 2014
Risk Manager's Signature: 1. Date:
c,ly ay
Financial Services
This Contract is conditioned ylSon appropriation by the Board of Commissioners Yes❑No A budget amendment is necessary
before approval Yes❑NoLV. 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 et and Fiscal Contro ct:
YaFinancial Services Director's Signature: *- 4�-e_ Date: Iqlly
County Attorney
Approval by Board ❑ (Contracts $90,000.00 9.r more for goods or services, $250,000.00 or more for construction, or any BOCC
consultant contract). Approval by Managerost other contracts$1,000 and above). Department Director approval only❑(Under
$1,000). This contract has been rvvievod and approved by the Attorney as to legal form and sufficiency:
Attorney's Signature -° Date: Z:l—"
County Manager
This contract has been reviewed and is ap ov by e County Manager Yes 1V
This contract has been reviewed and i si tur y air DNoo.
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