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lea— S7Q <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 /> Party/Vendor Name: Hudson Well Company Party/Vendor Contact Person: Paul Weller Contact Phone:919-417-6813 <br /> Party/Vendor Address:PO Box 05 City Rou eg, mont State:NC Zip:27572 Department: Solid Waste Amount: $5,576.00 Purpose: <br /> Water well drilling and commissioning Budget Code(s): 5035 3030 880000 Vendor#49654 (N/A if new vendor) Vendor is a BOCC <br /> consultant? Yes❑No® Contract Type: (Check one)New® Renewal❑ Amendment ❑ Effective Date 10/1/2012 Approved by <br /> Board Yes❑No® 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❑No❑ Bid/RFP number This contract has been reviewed and approved by the Department Director as to <br /> technical content: <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 techn ogy specifications: <br /> IT Director's Signature: Date: <br /> Ri k"Manaeement <br /> Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required E� 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:�� V/ Date: <br /> Financial Services <br /> This Contract is conditioned ypon appropriation by the Board of Commissioners Yes❑No[ A budget amendment is necessary <br /> before approval YesE:]NoM. 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 Budget and Fiscal Control Act: <br /> Financial Services Director's Signature: l,(4-{ ln..�� ,t/h. Date: Z <br /> County Attorney <br /> Approval by Board ❑ (Contracts $90,000.00 or more for goods or services, $250,000.00 or more for construction, or any BOCC <br /> consultant contract). Approval by Manager[9 (Most other contracts$1,000 and above). Department Director approval only❑(Under <br /> $1,000). This contract has be eviewed and approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: Vvihk. <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 signature by the Cjrair Yes❑No[3- <br /> Manager's Signature: Date: <br /> Clerk to the Board <br /> Approved by BOCC on the_day of 20 . Submitted for Chair signature on the_day of 120 <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />