HomeMy WebLinkAboutR 2014-543 EMS - NC Dept. of Public Safety for Emergency Management Performance Grant $35,000 c:Q0 P4 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: North Carolina Department of Public Safety Party/Vendor Contact Person: Ricky Tuddle Contact Phone: 919
825-2500 Party/Vendor Address:4236 Mail Service Center City Raleigh State:NC Zip:27699 Department:Emergency Management
Amount: $35,000.00 Purpose:Eryiergency Management Performance Grant Budget Code(s): 30750020 629000 71049 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:
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 T contract has been reviewed and approved by the Department Director as to
technical content: n
Department Director's Signature: Date: C% A;1I
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 Ins
Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as shoMy
by the Risk Manager:
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Risk Manager's Signature: a1J �.��". Date:
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Financial Services
This Contract is conditioned j�pon appropriation by the Board of Commissioners YesE]No 1[�. A budget amendment is necessary
before approval Yes[] No 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:
Financial Services Director's Signature: W ,�> A4,_ Date: /
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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 any BOCC
consultant contract). Approval b anager%(Most other contracts$1,000 and above). Department Director approval only❑ (Under
$1,000). This contract has been i'wed and approved by the Attorney as to legal form and sufficien y:
Attorney's Signature Date: C9
County Manager
This contract has been reviewed and is approved by the County Manager Yes ❑.
This contract has been reviewed and is for signature by the Chair Yes❑No❑.
Manager's Signature: Date:
Clerk 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