HomeMy WebLinkAboutR 2014-375 DSS - Information, Inc. for NC Daysheet Maintenance 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 specifies 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.
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Department
Party/Vendor Name: Information,Inc Party/Vendor Contact Person: Michael Bradley Contact Phone: Party/Vendor Address:
9961 NC Hwy 87N City Pittsboro State:NC Zip:27312 Department:DSS Amount: 60-600 Purpose:NC Daysheet maintenance
Budget Code(s): 10400120-63000 Vendor# (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract
Type:(Check one)New ❑ Renewal® Amendment ❑ Effective Date Approved by Board Yes❑No[] Agenda Date:
Title of Contract:NC Day Sheet Maintenance 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 number This contract has been reviewed and approved by the Department Director as to
technical content:
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 Manaeement
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 sh
by the Risk Manager: O
6 Risk Manager's Signature: J�, o Dater JUL 16 2014
Financial Services Bv
This Contract is conditioned upon appropriation by the Board of Commissioners Yes❑No❑. A bu
before approval Yes❑No❑. If budget amendment is necessary,please attach to this form. This instrument has bee re-audited in the
manner required by the Local Government Budget and Fiscal Control A t: 8`I `fool,"I c
Financial Services Director's Signature D e: L17
to l8y
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County Attorney
Approval by Board ❑ (Contracts $90,000.00 or more for goods or services, $250,000.00 or more for construction, or arly BOCC
consultant contract). AManager❑ (Most other contracts$1,000 and above). Department Director approval only (Under
$1,000). This contrachas a reviewed and approved by the Attorney as to legal form and sufficiency:
Attorney's Signature
Date:
County Manager
This contract has been reviewed and is approved by the County Manager Ye No❑.
This contract has been reviewed and„ for signature by the Chair Yes❑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