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ORANGE COUNTY—CONTRACT CONTROL SHEET �( d <br /> "'( �? -`'outing 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: Habitat for Humanity PartyNendor Contact Person: Susan Levy Contact Phone:919-932-7077 PartyNendor <br /> Address: 88 Vilcom Center Drive City Chapel Hill State:NC Zip:27514 Department: Housing/Human Rights and Community <br /> Development Amount: $175,000 Purpose:FY 2011 HOME Program Budget Code(s): 32473005 Vendor# (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes❑No11 Contract Type:(Check one)New❑ Renewal❑ Amendment 1 Effective Date <br /> 04/24/12 Approved by Board Yes It No❑ Agenda Date:05/03/2011 Title of Contract: Development Agreement Amendment <br /> If this is a Grant Agreement,pre-application has been approved by the Board of Commissioners Yes❑Non. If submitted for bid were <br /> bids/RFPs received Yes❑No❑ Bid/RFP number This contract has been reviewed and approved by the Department Director as to <br /> technical content: / <br /> Department Director's Signatu�•: Z. „MO �� Date: <br /> *5/7* <br /> ir <br /> IT or <br /> (Applicable only to hardware/software purchases or related servic ontract has been reviewed and approved by the Information <br /> Technology Director as to technical content and information tech ology specifications: <br /> IT Director's Signature: Date: <br /> ��c3e <br /> Risk 4ana. m•ntT *c. <br /> Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ ''fessional; ❑ Property; ❑ OR No Insurance Required O. Hold <br /> Contract pending receipt of Certificate of Insurance El. With in erpor• '•n of Insurance provisions as shown, this contract is approved <br /> by the Risk Manager: <br /> Risk Manager's Signature: Date: <br /> Financial Services, <br /> This Contract is conditione pon appropriation by the Board of Commissioners YesENo A budget amendment is necessary <br /> before approval Yes❑No If budget amendment is necessary,please attach to this form. i instrument has been pre-audited in the <br /> manner required by the Local Government Bud et d Fiscal Control Act: <br /> Financial Services Director's Signature: <br /> Date: S 13 l(/2-- <br /> County Attorney <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 M. •=er V:t `• II other contracts). This contract has been reviewed and approved by the Attorney as to legal <br /> form and sufficiency: <br /> WAIL. Date: I 2 Attorneys Signature �� <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Ye No❑. <br /> This contract has been reviewed and is to be su emitted for 'O C conside tion Yes❑ . <br /> Manager's Signature: I I Date: . I —/ v <br /> to the Board <br /> I <br /> Approved by BOCC on the'day of 20 /I . Submitted for Chair signature on the_day of 1 ,20 . <br /> Clerk's Signature: <br /> / Date: U ( `A k L <br /> J ) <br /> Revised April 2010 <br />