HomeMy WebLinkAboutR 2010-047 Animal Services ORANGE COUNTY-CONTRACT CONTROL SHEET C f-7
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: Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: City
State: Zip: Department: Amount: Purpose: Budget Code(s): 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 This contract has been reviewed and approved by the Department Director as to
technical content:
Department Director's Signature: t/ 1LY�1
� 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 informa ' chnology specifications:
IT Director's Signature: Date:
Risk Management
Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; ❑ OR No Insurance Required El. Hold
Contract pending receipt of Certificate of Insuran With incorporation of Insurance provisions as shown, this contract is approved
by the Risk Manager:
Risk Manager's Signature: Date:
Financial Services
This Contract is conditioned upon appropriation by the Board of Commissioners Yes❑NoxJ. A budget amendment is necessary
before approval Yes❑No ff 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: qa4UCC, J+,k— Date: � L t
County Attornev
Approval by Board ❑ (Contra over $90,000.00 for goods or services, $250,000.00 for construction, or any BOCC consultant
contract). Approval by Man er ct (All other contracts). This contract has been reviewed and approved by the Attorney as to legal
form and sufficiency:
Attorney's Signature Date: fa l O
County Manager
This contract has been reviewed and is approved by the County Manage Ye No❑.
This contract has been reviewed and is to be submitted for BOCC con ' er tion Yes❑N
Manager's Signature: Date: 6a 7 (J
Clerk to L Board
Approved by BOCC on the d o ,20 Submitted for Chair signature on the day of ,20
Clerk's Signature: Date: "
Akt /�/ 'f
�
Revised April 2010