2012-073 NS Attorney - Health System Properties LLC $59,782.16

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pV)-- ORANGE COUNTY—CONTRACT CONTROL SHEET , .110* , s 04 e ' ,. e. .' A i 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: Health System Properties,LLC Party/Vendor Contact Person: William L. Roper Contact Phone: (919)966-0692 PartyNendor Address: 101 Manning Drive,4th Floor, Wing E City Chapel Hill State:NC Zip:27514 Department: County Attorney Amount: $59,782.16 Purpose: Eastowne Parcel Tract 3b Budget Code(s): Vendor# (N/A if new vendor) Vendor is a BOCC consultant? Yes [1]No Contract Type: (Check one)New[E] Renewal E Amendment El Effective Date January 6,2012 Approved by Board YesE]No0 Agenda Date: Title of Contract: If this is a Grant Agreement,pre-application has been approved by the Board of Commissioners YesID Nop. If submitted for bid were bids/RFPs received YesEl NoE1 Bid/RFP number This contract has been reviewed and approved by the Department Director as to technical content: Department Director's Signature: 67211 :7 Date: 3 .2-1 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: Ni 141 Date: Risk Management Include the following coverages: 0 CGL; El Auto; E] WC; 0 Professional; 0 Property; OR No Insurance Required E. Hold Contract pending receipt of Certificate of Insurance Ea With incorporation of Insurance provisions as shown, this contract is approved by the Risk Manager: Risk Manager's Signature: N IA- Date: Financial Services This Contract is condition upon appropriation by the Board of Commissioners YesEINo . A budget amendment is necessary before approval Yes[]No . If budget amendment is necessary, please attach to this form. h instrument has been pre-audited in the manner required by the Lo1 Government B t and Fiscal Con I Act: Financial Services Director's Signature: Date: Z,'I I ( -1-- County Attorney Approval by Board 0 (Contracts $90,000.00_or more for goods or services, $250,000.00 or more for construction, or any BOCC consultant contract). Approval by ManagerE(Most other contracts$1,000 and above). Department Director approval only 0 (Under $1,000). This contract has been viewed and approved by the Attorney as to legal form and sufficiency: / el , Attorney's Signature ir I , Date: / County Manager This contract has been reviewed and is approved by the County Manager YegEr-No0. This contract has been reviewed and is for signature by the Chair YesE]NoEfr.— '01L.C. .—? Date: 3 -29-- / z--- Manager's Signature: Cler to the Board Cl' /1•■ ,20 Approved by BOCC on the day of , 0 Ai . Su-,mitted for air signa re o the day Clerk's Signature: I Date: 3 z__ c4 teAtia'frul ,o-ip Revised March 2012 id-14/11jd