2012-388 S Planning - J F Wilkerson Contracting Company Future Connection stub-out on N Oak St $22,496.60

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cola -�8 ORANGE COUNTY-CONTRACT CONTROL SHEET 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: J.F.Wilkerson Contracting Company Party/Vendor Contact Person: Joseph Wilkerson Contact Phone:919-467- 1829 Party/Vendor Address: 10710 Chapel Hill Road City Morrisville State:NC Zip:27560 Department:Planning Amount: $22,496.60 Purpose: Change Order#4-Future connection stub-out on the force main at North Oak Street Budget Code(s): 61370035- 880000-30042 Vendor#55607 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type: (Check one)New ❑ Renewal❑ Amendment ® Effective Date 8/21/2012 Approved by Board Yes®No❑ Agenda Date: 8/23/2011 Title of Contract: Sanitary Sewer Improvements for Buckhorn Area North of I-85&Central Efland i° 2 wal z If this is a Grant Agreement,pre-application has been approved by the Board of Commissioners Yes❑No❑. If submitted for bid were bids/RFPs received Yes❑Non Bid/RFP number This contract has been reviewed and approved by the Department Director as to technical content: Cc Department Director's Signature Date: 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: Date: Risk Management Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required [j+'. Hold Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as shown,this contract is approved by the Risk Manager: Risk Manager's Signature: 1 �''U' ✓/ V`— Date: Z. Financial Services This Contract is conditioned on appropriation by the Board of Commissioners Yes No A budget amendment is necessary before approval Yes❑NoM. If budget amendment is necessary,please attach to this form. This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Financial Services Director's Signature: U1•ly A )V,�,� Date: 10 23 1 L County Attorney Approval by Board ❑ (Contracts $90,000.00 or more for goods or services, $250,000.00 or more for construction, or any BOCC consultant contract). Approval by Manager r)§(Most other contracts$1,000 and above). Department Director approval only❑ (Under $1,000). This contract has been reviewed and approved by the Attorney as to legal form and sufficiency: Attorney's Signature Date: 10/�� ' *M,l ,R; Av rNvk,z1 D , 1 lv CO c ��o s o .e C /%%i o c c ©N County Manager This contract has been reviewed and is approved by the County Manager YesENo❑. This contract has been reviewed and is for signature by the C air Yes❑No❑. Manager's Signature: \ Date: Clerk to the Board Approved by BOCC on the_day of 20 . Submitted for Chair signature on the_day of 20 Clerk's Signature: Date: Revised March 2012