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HomeMy WebLinkAboutR 2019-475 Planning - Interlocal agreement for Historic Rogers Road Sewer Connection cost sharing ,;2 Ll 7 S ORANGE COUNTY-DEPARTMENT USE ONLY Party/Vendor Name : Party/Vendor Contact Person : Contact Phone : Party/Vendor Address : City State . Zip : Department . Amount : $ 138 , 510 . 00 (Chapel Hill and Carrboro) Purpose : Interlocal Aareement with Town of Carrboro and CH for reimbursement for installati ivate sewer service lateral connections for low to moderate income Budget Code(s) : 61610007449925W 6 0007 -449926 { O 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 : This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has not been initiated prior to execution of the agreement : n Department Director ' s Signature Date : Agreements for emergency services or repair a not subject to the above affirmation . If servic relate to this agreement have already begun or been comp eted please briefly describe the nature of the emergency condition that was addressed : Information Technologies (Applicable only to hardware/software purchases or related services) This agreement has been reviewed and is approved as to information technology content and specifications : Office of the Chief Information Officer Date : Risk Management This agreement is approved for sufficiency of insurance standards , specifications , and requirements : Office of the Risk Management Officer Date : Financial Services This instrument has been pre - audited in the r requ ' ed by the Loc 1 Government Budget and Fiscal Control Act : Office of the Chief Financial Officer CJ" Date : 7 3 O t C Legal Services This agreement is approved as to legal form and sufficienc Office of the County Attorney JDate : �j /f Clerk to the Board Received for record retention : All Docusign contracts must be copied to Sherri Ingersoll up n completion : smgersoll@orangecountync . gov The following signature block is for hard copies only and is of required for Docusign contracts: Office of the Clerk to the Board Date : ` r Revised 12/ 18