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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: Burke Design Group Party/Vendor Contact Person: Ben Burge,PE Contact Phone:919-771-1916 Party/Vendor <br /> Address:3305-109 Durham Road City Raleigh State:NC Zip:27603 Department:AMS Amount:$25,000 Purpose: SportsPlex Entry <br /> Renovations Budget Code(s): 53530030-870000 Vendor#60926 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No❑ <br /> Contract Type: (Check one)New® Renewal❑ Amendment ❑ Effective Datel2t14 J3Approved by Board Yes❑No❑ <br /> 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: ,_ °�_ Date: 2' 2• /3 <br /> IT Director <br /> (Applicable only to hardware/software purchases or related erv.ces)This contract has been reviewed and approved by the Information <br /> Technology Director as to technical content and inform ti technology specifications: <br /> 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 Insurance ❑. With incorporation of Insurance provisions as shown,this contract is approved <br /> by the Risk Manager: <br /> Risk Manager's Signature: aA" C� (�u Date: <br /> IZA.=1 <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[Z 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 o Control Act:: <br /> .�-� �J <br /> Financial Services Director's Signature: aay-v, A. Jnv— Date: 14 1 <br /> County Attorney <br /> Approval by Board ❑ (Contracts $90,000.00 ore 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 been reviewed and 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 d by the County Manager Yes-lo❑. <br /> This contract has been reviewe d ' si ature y th a. 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 ,20 <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />