HomeMy WebLinkAboutR 2014-181 ES - OC Speedway Management for EMS standby during races teal
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: Orange County Speedway Management,LLC Party/Vendor Contact Person: Terry Deal Contact Phone:
Party/Vendor Address:9740 NC Hwy 57 City Rougemont State:NC Zip:27572 Department:Emergency Services Amount:�
Purpose:EMS Standby during Races Budget Code(s): Vendor# (N/A if new vendor) Vendor i 3 a BOCC consultant?
Yes❑No® Contract Type: (Check one)New❑ Renewal❑ Amendment ❑ Effective Date 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 Thi contract has been reviewed and approved by the Department Director as to
technical content: r�
Department Director's Signatur Date: l
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 Insurance Required ❑. Hold
Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as show
by the Risk Manager: D 'Tun TY
Risk Manager's Signature: Date: APR — 2014
Financial Services
This Contract is conditioned u n appropriation by the Board of Commissioners Yes❑No[� A budg
before approval Yes❑No�f 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:
Financial Services Director's,Signature: l )) . / Date: l7
County Attorney
Approval by Board ❑ (Contracts $90,000 00 or more for goods or services, $250,000.00 or more for cor struction, or any BOCC
consultant contract). Approval Manager((Most other contracts$1,000 and above). Department Director approval only❑ (Under
$1,000). This contract has be r iew a approved by the Attorney as to legal form and suffic'ency:
Attorney's Signature Date:
County Manager
This contract has been reviewed and is approved by the County Manager Yes No❑.
This contract has been reviewed and is to signat 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