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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: Siemens InduM,INc. Party/Vendor Contact Person: Will Tattersall Contact Phone:919-469-5095 P 1'?Viendor <br /> Address:215 Southport Drive City Morrisville State:NC Zip:27560 Department:Asset Management Services Amount- 7720 0 <br /> j� <br /> Purpose:Technical support service s <br /> Budget Code(s): 10240320 630000 Vendor#53325 (N/A if new vendor) Vendo i a BOCQ. -,' <br /> consultant? Yes❑NoO Contract Type:(Check one)New[D Renewal ElAmendment ❑ Effective Date 07/01/2 12 A ed by <br /> Board Yes❑NoO 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:n Date: t L t <br /> V <br /> IT Director <br /> (Applicable only to hardivarelsoftivare 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: <br /> Risk Management <br /> Include the following coverages: EYCGL; [/Auto; 0 WC; 9Professional; ❑ 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: Date-, <br /> Financial Services <br /> This Contract is conditioned on appropriation by the Board of Commissioners Yes❑Nolp/ A budget amendment is necessary <br /> before approval YesE]NoEff, 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: ) <br /> .1� "I,— Date: 2- -12- -3 <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 ManageZ2_fmost other contracts$1,000 and above). Department Director approval only❑(Under <br /> $1,000). This contract has been reviewed approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Yesolq0-0. <br /> This contract has been reviewed an signa re by t e Chair Yes❑NoET__ <br /> Manager's Signature: Date: ----Lr1 5, <br /> Clerk to the Board <br /> Approved by BOCC on the day of 20—. Submitted for Chair signature on the T day of__,20_. <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />