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�-lob <br /> ORANGE COUNTY-CONTRACT CONTROL SHEET <br /> Routing Order: (1)Department, (2)IT,(3)Risk Managemen,(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: Efland Fire Department Party/Vendor Contact Person: Kevin Brooks Contact Phone:919-732-8941 Party/Vendor <br /> Address:P.O.Box 39 City Eflan d State:NC Zip:27243 Department:Emergency Services Amount: Purpose:Fire Protection <br /> Agreement 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 Approved by Board Yes®No❑ Agenda Date: <br /> 11/19/2013 Title of Contract:Fire Protection and Emergency Services Agreement <br /> If this is a Grant Agreement,pre-application has been approve by the Board of Commissioners Yes❑No❑. If submitted for bid were <br /> bids/RFPs received Yes❑No❑ Bid/RFP nu ber T contract has been reviewed and approved by the Department Director as to <br /> technical content: / ,/ n <br /> Department Director's Signature: Date: l Sri aC,01cl, <br /> IT Director <br /> (Applicable only to hardware/softwar 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 /> 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: Date: ? <br /> Financial Services <br /> This Contract is condi 'oned upon appropriation by the Board of Commissioners YesENo❑. A budget amendment is necessary <br /> before approval YesMNo❑. 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 Budg t and Fiscal Control Act: <br /> Financial Services Director's Signature: Date: 117LI <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❑(Most other contracts$1,000 and above). Department Director approval only❑ (Under <br /> $1,000). This contract has bees re 'ewed an p 'oved 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 approved by the County Manager Yes[]No❑. <br /> This contract has been reviewed and is for signature by the 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 ,20 <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />