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C "-2 Q��?j'd 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: North Chatham Fire Department Party/Vendor Contact Person: Chief John Strowd Contact Phone: 919-542-3380 <br /> Party/Vendor Address:45 Morris Rd City Pittsboro State:NC Zip:27312 Department: Amount: Purpose:Fire <br /> Protection Budget Code(s): Vendor# (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract <br /> Type: (Check one)New❑ Renewal® Amendment ❑ Effective Date July 8,2013 Approved by Board Yes®No❑ Agenda <br /> Date:June 18,2013 Title of Contract: Fire Protection and Emergency Services Agreement <br /> If this is a Grant Agreement,pre-application has been approved by the Boaj6 of Commissioners Yes❑No❑. If submitted for bid were <br /> bids/RFPs received Yes❑No[–] Bid/RFP er This contract been reviewed and approved by the Department Director as to <br /> technical content: / <br /> Department Director's Signature: Date: ` <br /> IT Director <br /> (Applicable only to hardware/software urchases 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 /> Y` IT Director'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 I surance With incorporation of Insurance provisions as shown,this contract is approved <br /> by the Risk Manager: <br /> Risk Manager's Signature: Date: <br /> toH <br /> Financial Services <br /> This Contract is condit' ned upon 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 Bud et nd Fiscal Control A l <br /> Financial Services Director's Signature: L'� Date: <br /> LZA b <br /> County Attorney <br /> Approval by Boa (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❑ (Most other contracts$1,000 and above). Department Director approval only❑ (Under <br /> $1,000). This contract has bee rev' wed and approved by the Attorney as to legal form and sufficiency: <br /> + <br /> Attorney's Signature Date: �2_ <br /> County Manager <br /> This contract has been reviewed and is a ov y the Coun M 6pger Yes10❑. <br /> This contract has been reviewed is si a re he air s❑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 20 <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />