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,2Wiz-tx6 <br />O1 ANG C STN Y CONTRACT CON'T'ROL SHEET <br />Routing Order: x Dpainent, 2 IT, 3 Risk Management, Financial Services, Attorney, 6 Manager, Clerk <br />This Document shall accompany all contracts and shall be submitted for signature in the Routing Order specified above. If the Manager <br />d tormm* es the contract is not appropriate for Manager approval the Manager shall submit the contract for BOCC approval. Contracts for <br />BOCC approval must be submitted through, and complete, the routing process prior to agenda review. Contracts for legal review should <br />be completed through the legal review process prior to being routed for signature. <br />Department <br />Party endow Name: R.S. Job & Associates Party Vendor Contact Person: Robert S. Jones, PLS Contact Phone: (919)563 -3623 <br />Party end r Address: 121 W. Clay Street, Suite A City Mebane State: NC Zip: 27302 Department: Pl�in�lnspections Amount: <br />$1 1,850 Purpose: Boundary Survey Budget Odes : 10620120630000 Vendor # 57711 I A if new vendors Vendor i a BD C <br />consultant? Yes � <br />❑ o� c�ontract Typ e: (Cheek one) New M Renewal [:1 Amendment ❑ Effective Date 01 18/2012 Approved by <br />Board Yes❑ o[A Agenda Date: Title of Contract: Professional Services <br />If this is a Grant Agreement, pre-application has been approved by the Board of Commissioners Yes❑ No ❑. If submitted for bid were <br />bids FPs received Yes❑ N ® Bid/ P number This contract as been reviewed and approved by the Department Director a to <br />technical content: <br />Department Director's Signature; �........ Date:- zlle4l�ee <br />IT Director <br />(Applicable only to h ere of ware pui-chases or resorted set - vices) This contract has been reviewed and approved by the Information <br />Technology Director as to technical content and information technology specifications: <br />IT Director's Signature: <br />Risk Management <br />Date: <br />Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; Professlon l; ❑ Property.; ❑ DID No Insurance Required [j. Hold <br />Contract pending receipt of Certificate of Insurance E]. With incorporation of Insurance provisions as shown, this contract is approved <br />by the Disk Manager: <br />Kish Manager's Signature: Date: <br />Financial Services <br />This Contract is conditione,,d ypon appropriation by the Board of Commissioners YesE]No A budget amendment is necessary <br />before approval Yes❑ No [M. If budget amendment is necessary, Please attach to this form. This instrument has been pre-audited in the <br />4 manner required by the Local Government Budget and Fiscal Control Act: <br />Financial Services Director's Signature: Date: <br />County Attorne <br />Approval by Board ❑ (Contracts over $90,000.00 for goods or services, $250,000.00 for construction, or any BOCC consultant <br />contract). Approval by Manager H (All other contracts). This contract has been reviewed and approved by the Attorney as to legal <br />form and sufficiency: <br />Attorney's Slignature Date: 3 <br />County Manauer <br />This contract has been reviewed and is approved by the County Manager Ye�❑'�o ❑. <br />This contract has been reviewed and is to be su xnitted for BOCC consideration Yes [:]N : <br />?` `� <br />Manager's Signature: :. Date: <br />erl to the Board <br />Approved by B C on the day of Submitted for i signature on the day f , 20 <br />Clerk's Signature: Date: z �. <br />4 <br />Revised April 2010 <br />