HomeMy WebLinkAboutR 2010-023 DEAPR - Jerri Morris e) -,;,
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.
r Department �
70 �T�Party/Vendor Name:4r��S Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: F1%� "I*pe
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State: fi(_ Zip:2-7 27g Department: P`,(z Amount:5,4-o Purpose: Budget Code(s): Vendor# (N/A if new
vendor) Vendor is a BOCC consultant? Yes ❑No[Z Contract Type: (Check one)New X Renewal ❑ Amendment ❑ Effective
Date Approved by Board Yes❑NoD 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 forbid
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: gp s /a
E/ IT Director
(Applicable only to hardware/software purchases or related services)This contract has been reviewed and approved by the Information
Technolo y Director as to technical content and information technology specifications:
IT Director' ignature: Date:
Risk Management
Include t e following coverages: ❑ CGL; El Auto; ❑ WC; ❑ Professional; ❑ Property; ❑ OR No Insurance Required ❑. Hold
Contract pending receipt of Certificate of Insurance E]. With incorporation of Insurance provisions as shown, this contract is approved
by the Risk Manager:
Risk Manager's Signature:-qm Date:
I�C Ice 2_1S12 O 10
Financial Services
This Contract is conditioned upon appropriation by the Board of Commissioners Yes❑No❑. 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 Budg t and Fiscal Control Act:
Financial Services Director's Signature: &4, Y Date:
County Attorney
Approval by Board ❑ (Contracts over $25,000.00 or any BOCC consultant contract). Approval by Managerkji (All contracts
$25,000.00 or less with the exception of BOCC consultants). This contract has been reviewed and approved by the Attorney as to legal
form and sufficiency:
Attorney's Signature Date:69
County Manager
This contract has been reviewed and is approved by the County Manager Ye No[:].
This contract has been reviewed and to be sub ed for BOCC consideration Yes❑NOL�
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Manager's Signature: _ e Date:
Clerk to the
Board
bmi for Chair signature:
C rk's nature: Date:
Revised December 2009