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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: Shackelford&Associates Party/Vendor Contact Person: Jay Shackelford Contact Phone• 2-21 -2250 <br /> Party/Vendor Address:PO Box 30924 City Greenville State:NC Zip:27833 Department: DEAPR Amou 2 50 urpose: <br /> Conservation easement appraisal(Lands Leg_acy Program)as authorized by BOCC Budget Code(s): 6137V;35 02 20006 Vendor# <br /> 57220 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No❑ Contract Type: (Check one)tewZ Renewal❑ <br /> Amendment ❑ Effective Date MU 28,2013 Approved by Board Yes®No❑ Agenda Date: Title of Contract: <br /> Conservation Easement Appraisal for the Bliss-Dobyns property <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: Date: SJ 2$ <br /> IT Director <br /> (Applicable only to har re/software purcha related services)T ntract has been sewed and approve a Information <br /> Technology Dir r as to technical con and information tec ogy specifications: <br /> IT Di ector's Signature: Date: <br /> Risk Management <br /> Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ 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: .�. M�"'� Date: G t <br /> -?�. slz8 <br /> Financial Services <br /> This Contract is conditioned on appropriation by the Board of Commissioners Yes No A budget amendment is necessary <br /> before approval Yes❑ No[�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: aa, . i A A40, Date: <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 Manager.21"(Most other contracts$1,000 and above). Department Director approval only❑ (Under <br /> $1,000). This contract has been revs wed and a ove by the Attorney as to legal form and sufficiency:: <br /> Attorney's Signature Date: <br /> County Manag <br /> This contract has been reviewed and is approved by County Manager Y er No❑. <br /> This contract has been reviewed and ' r s' e Chair Yes❑No❑� <br /> Manager's Signature: !/ Date: <br /> Clerk to the Board <br /> Approved by BOCC on the day of ,20 . Submitted for Chair signature on the_day of 120 <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />