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010/61 - /is <br /> ORANGE COUNTY—CONTRACT CONTROL SHEET <br /> Routing Order: (1)Department,(2)IT,(3)Risk Management,(4)Financial Services,(5)Attorney,(6)Manager,(7)Clerk <br /> This Document shall accompany all contracts and shall be submitted for signature in the Routing Order specified above. If the Manager <br /> determines 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 /> PartyNendor Name: MXN Corporation PartyNendor Contact Person: Bob Patrick Contact Phone: Party/Vendor Address:PMB <br /> 306 1025 Rose Creeck Dr.,#620 City Woodstock State: GA Zip: 30189 Department: Amount: $41,558.23 Purpose: Install <br /> Wireless Network Budget Code(s): 61370035 897119 30007 Vendor#NA (N/A if new vendor) Vendor is a BOCC consultant? Yes <br /> ❑No® Contract Type: (Check one)New® Renewal❑ Amendment ❑ Effective Date Approved by Board Yes[]No <br /> Agenda Date: Title of Contract: <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/RFPs received Yes❑Nor] Bid/RFP number This contract has been reviewed and approved by the Department Director as to <br /> technical content: <br /> _^ 52.2•?�'�--- <br /> Department Director's Signature: Date: <br /> IT Director <br /> (Applicable only to hardware/software purchases or related services)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: *' ± ■ .'= Date: 5 .22. . o k <br /> Risk Management <br /> Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required Hold <br /> Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as shown, this contract is approved <br /> by the Risk Manager: <br /> Risk Manager's Signature: , Vie- LQJ Date: 5.15. 1 L <br /> etc d.24..x.`y n 612z/lz <br /> + er.�o <br /> Financial Services <br /> This Contract is condition d upon appropriation by the Board of Commissioners Yes❑No. A budget amendment is necessary <br /> before approval Yes❑Nol. If budget amendment is necessary,please attach to this form. This instrument has been pre-audited in the <br /> manner required by the Local Government Bud t d Fiscal Control Act:/j <br /> Financial Services Director's Signature: Wt.4-4._.. i% i Date: ,/l 1(Z <br /> County Attorney <br /> Approval by Board ❑ (Contracts $90,000.00 o more for goods or services, $250,000.00 or more for construction, or any BOCC <br /> consultant contract). Approval by Manager (M�ost other contracts$1,000 and above). Department Director approval only❑ (Under <br /> $1,000). This contract has been revie ed and approved by the Attorney as to legal form and sufficiency: <br /> tC//k <br /> Attorney's Signature �•/� Date: <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Yes{ No❑. <br /> This contract has been reviewed and is for signa e by t'e Chair Yes❑NeJ <br /> , <br /> 1 0 <br /> Manager's Signature: ' / Date: G — et --/z---- <br /> Clerk to oard <br /> Approved by BOCC on the day of ,/ ed for Chair signature on the day of ,20 . <br /> Clerk's Signature: / � Date: /Z <br /> Revised March 2012 <br />