HomeMy WebLinkAboutR 2015-165 AMS - Lomax Construction Co, Inc. - Change Order #2 unforeseen field conditions (contingency) allowance reconciliation
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: Lomax Construction Company,Inc. Party/Vendor Contact Person: Charlie Johnson Contact Phone:336-992-
7000. Party/Vendor Address:PO Box 35169 City Greensboro State:NC Zip:27425 Department:AMS Amount: $13,050 Purpose:
Proposed Change Order#2-unforeseen field conditions(contin ency),allowance reconciliation Budget Code(s):61370035-880000-
10028 Vendor#62290 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type:(Check one)New❑
Renewal❑ Amendment ® Effective Date 2/23/15 Approved by Board Yes®No❑ Agenda Date: 12/10/13 Title of Contract:
Whiffed Meeting,Room
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®Nor-1 Bid/RFP number 1218This 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: x 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 shown,this contract is approved
by the Risk Manager: D � 9 � [I L'1
Risk Manager's Signature: Date:
III MAR 3 1 2015
Financial Services
l
This Contract is conditioned upon appropriation by the Board of Commissioners Yes❑No❑. A �dgetamench;nent is necess before approval Yes❑No❑. If budget amendment is necessary,please attach to this form. This instru e
manner required by the Local Government B and Fiscal Control Act:
Financial Services Director's Signature: I 1:1t `2IM 0Qe_6?k Date:
ly
County Attorney
Approval by Board ❑ (Contracts $901000.00 r 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 begn reviewed and a roved by the Attorney as to legal form and sufficiency:
Attorney's Signature �— Date:
i
County Manager
This contract has been reviewed and is approved by the County Manager Yes[9 No❑.
This contract has been reviewed and is for signature by the C'h�air�Yes❑No❑.
Manager's Signature: /� I .N` Date: 7
Clerk to the Board
Approved by BOCC on the day of ,20 . Submitted for Chair signature on the day of 120
Clerk's Signature: Date:
Revised March 2012