R 2013-020 Solid Waste - NC DOT for Storm Debris Management MOA $ 0

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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: NC DOT Party/Vendor Contact Person: Joseph Turmer Contact Phone:919-835-8428 Party/Vendor Address: NCDOT 1567 Mail Service Center City Ralei State:NC Zip:27699 Department: Solid Waste Amount:LO Purpose:MOA Budget Code(s): Vendor# 14415 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type:(Check one)New ® Renewal❑ Amendment ❑ Effective Date Of Signature Approved by Board Yes❑No® Agenda Date: Title of Contract: If this is a Grant Agreement,pre-application has been approved by the Board of Commissioners Yes❑Non. 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: 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: {jA Date: Risk ManaEement Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required &.. 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: Date: p� Financial Services This Contract is conditioned on appropriation by the Board of Commissioners Yes❑Noy A budget amendment is necessary before approval Yes❑NoIf 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:A,-- /Financial Services Director's Signature: a - " Date: �a! 3 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[9(Most other contracts$1,000 and above). Department Director approval only❑ (Under $1,000). This contract has been viewed and approved by the Attorney as to legal form and sufficiency: Attorney's Signature Date: County Manazer This contract has been reviewed and is approved by the�ounty Manager Ye$jEfNo❑. This contract has been reviewed and is fo ignature hair Yes❑No[Z Manager's Signature: Date: l - /Y/ / Clerk to the Board Approved by BOCC on the—day of 120 Submitted for Chair signature on the_day of ,20 Clerk's Signature: Date: Revised March 2012