2012-125 IT - MXN for Installing Wireless Network

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a01d - 4s- 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: MXN Corporation Party/Vendor Contact Person: Bob Patrick Contact Phone: Party/Vendor Address: PMB 306 1025 Rose Creeck Dr. #620 City Woodstock State: GA Zip: 30189 Department: Amount: $41,558.23 Purpose: Install Wireless Network Budget Code(s): 61370035 897119 30007 Vendor # NA (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: Date: ,� • 20T-21 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: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required Q Hold Contract pending receipt of Certificate of Insurance El. With incorporation of Insurance provisions as shown, this contract is approved by the Risk Manager: Risk Manager's Signature:, LQJ Date: CJ l 3 Z Financial Services This Contract is condition d 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 Bud t /�d Fiscal Control Act. Financial Services Director's Signature: UiL�, / %� Date: (Z- County Attorney Approval by Board ❑ (Contracts $90,000.00 o 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 been revie A 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 Manager YesENo❑. This contract has been reviewed and is for signat re by toe Chair Yes❑Ne� Manager's Signature: Date: Clerk to the Board Approved by BOCC on the _ day of , 20 . Submitted for Chair signature on the _ day of , 20 Clerk's Signature: Revised March 2012 Date: