2011-388 ED - Fickle Creek Farm for Piedmont Food and Agriculture Processing Center facility use

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3V 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: Fickle Creek Farm Party/Vendor Contact Person: Ben Bergmann Contact Phone:919-304-6287 Party/Vendor Address:4122 Buckhom Road City Efland State:NC Zip:27243 Department:Economic Development/PFAP Amount: Purpose:Use of facility Budget Code(s): Vendor# (N/A if new vendor) Vendor is a BOCC consultant? Yes r-1 NoN Contract Type:(Check one)New Z Renewal❑ Amendment ❑ Effective Date 12/01/2011 Approved by Board Yes❑Noz Agenda Date:NA Title of Contract:User Services Contract If this is a Grant Agreement,pre-application has been approved by the Board of Commissioners Yes❑NoZ. If submitted for bid were bids/RFPs received Yes❑No❑ Bid/RFP number This contract has been reviewed and approved by the Department Director as to technical content: Department Director's Signature: Date: IT Dire or (Applicable only to hardwarelsoftware 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: , r4 Date: Risk Management include the following coverages: 0�(CV Ruto; ❑ WC; ❑ Professional; ❑ Property; ❑ OR No Insurance Required El. Hold Contract pending receipt of Certificate of Insurance.EgC_4Vith incorporation of Insurance provisions as shown,this contract is approved by the Risk Manager: Risk Manager's Signature: 4=f:,A Date: 1 )-%P Financial Services This Contract is condition Ed ypon appropriation by the Board of Commissioners Yes❑NOX A budget amendment is necessary before approval Yes❑No If budget amendment is necessary,please attach to this form. This instrument has been pre-audited in the manner required by the Locral Government Budget and Fiscal C I Act: Financial Services Director's Signature: A o OdA,.A, Date: /0 it County Attorney Approval by Board ❑ (Contracts over $90,000.00 for goods or services, $250,000.00 for construction, or any BOCC consultant contract). Approval by Manager (All other contracts). This contract has been reviewed and approved by the Attorney as to legal form and sufficiency: Attorney's Signature County Manager This contract has been reviewed and is approved by the Count"(Manager Yes on This contract has been reviewed and is ub e B CC consideration Yesouer_r� 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 April 2010