HomeMy WebLinkAboutR 2011-023 AMS - Energie Innovation low emmisive ceiling installation ORANGE COUNTY—CONTRACT CONTROL SHEET S] .No , Z3
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
o be completed through the legal review process prior to being routed for signature.
ugoou Department
Party/Vendor Name: Energie Innovation,Inc. Party/Vendor Contact Person: Ive Baljak Contact Phone: 514-334-3783 Party/Vendor
Address:2970 Halpern Street City St-L te: Quebec(Canada) Zip:H45 1R2 Department:AMS Amount: $49,780 Purpose:
Low Emissivity Ceiling installation, �es get Code(s):to be determined in budget amendment Vendor#N/A (N/A if new
vendor) Vendor is a BOCC consulto® Contract Type: (Check one)New® Renewal❑ Amendment ❑ Effective
Date date of execution 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 367-1600This 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 Management
Include the following coverages: B'CGL; ['Auto; El-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:
Risk Manager's Signature: P"K Date:
Financial Services
This Contract is conditioned upon appropriation by the Board of Commissioners Yes❑No A budget amendment is necessary
before approval Yes❑Nom. If budget amendment is necessary,please attach to this form. Th s instrument has been pre-audited in the
manner required by the Local Government Budget and Fiscal Control Act:
Financial Services Director's Signature: V �. 4W,.+ Date:
County Attorney
Approval by Board ❑ (Contracts over $90,000.00 for goods or services, $250,000.00 for construction, or any BOCC consultant
contract). Approval by Manager�All other contracts). This contract has been 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 11anager Y RffNo❑. � L)
This contract has been reviewed and is to be submitte for BO c sideration Yes❑No .� �-7)Manager's Signature: Date: ^
Xerk to the Board
Approved by BOCC on the day of ,20 1 Submitted for C afore on the day of 920
Clerk's Signature: Date:
Revised April 2010