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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: Habitat for Humanity Party/Vendor Contact Person: Susan Levy Contact Phone:919-932-7077 Party/Vendor <br /> Address: 88 Vilcom Center Drive City Chapel Hill State:NC Zip:27514 Department:Housing/Human Rights and Community <br /> Development Amount:$75,000 Purpose:FY 2012 HOME Program Budget Code(s):32473005 Vendor 4 (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes❑Noo Contract Type:(Check one)New❑ Renewal❑ Amendment E Effective Date <br /> 01/02/13 Approved by Board YesZ No❑ Agenda Date:05/01/2012 Title of Contract:Development Agreement Amendment <br /> If this is a Grant Agreement,pre-application has been approved by the Board of Commissioners Yes❑Noo. 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 t-�� Date: <br /> IT *r ctor <br /> (Applicable only to hardwarelsoftware purchases or related service 4TIhiscontract has been reviewed and approved by the Information <br /> Technology Director as to technical content and information techn to specifications: <br /> IT Director's Signature: Date: <br /> Risk Ma dement <br /> Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; El^esional; ❑ Property; F-1 OR No Insurance Required V. Hold <br /> orno <br /> Contract pending receipt of Certificate of Insurance E]. With in orpo tion of Insurance provisions as shown,this contract is approved <br /> by the Risk Manager: <br /> Risk Manager's Signature: A I A fv Date: <br /> *car-- Z--o I I=,, <br /> Financial Services <br /> This Contract is conditioned 9pon appropriation by the Board of Commissioners Yes❑Nod A budget amendment is necessary <br /> before approval Yes❑No[g. 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: A A, Date: 13 <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 Manager (All other contracts). This contract has been reviewed and approved by the Attorney as to legal <br /> form and sufficiency: <br /> Attorney's Signature Date: 3 <br /> County Manner <br /> This contract has been reviewed and is approved by the County Mapazer YesE?etO'❑. <br /> This contract has been reviewed and is to be sub * d f BO sideration Yes[:]N6[1---- <br /> Manager's Signature: t= Date: <br /> Cleryto the Board <br /> Approved by BOCC on the day of 120 . Submitted for Chair signature on the_day of 20 <br /> Clerk's Signature: Date: <br /> Revised April 2010 <br />