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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: Stewart-Cooper-Newell Architects,Inc. Party/Vendor Contact Person: Ken Newell Contact Phone:704-865-6311 <br /> Party/Vendor Address:719 East Second Avenue City Gastonia State:NC Zip:28054 Department:AMS Amount:$32,800.00 ��� <br /> Purpose:Emergency Services Station Prototype Design Budget Code(s):61370035-870000-10053 Vendor#N/A (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes❑No® Contract Type:(Check one)New® Renewal❑ Amendment ❑ Effective Date 1/6/14 <br /> Approved by Board Yes❑No❑ Agenda Date:N/A Title of Contract:EMS Prototype <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 5194This contract has been reviewed and approved by the Department Director as to <br /> technical content: <br /> Department Director's Signature: --- Date:—,,'. 2 <br /> IT Director <br /> (Applicable only to hardware/software purchases or related s ices)This contract has been reviewed and approved by the Information <br /> Technology Director as to technical content and inform chnology specifications: <br /> IT Director's Signature: Date: <br /> Risk Management <br /> Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance R wired ❑. Hold <br /> Contract pending receipt of Certificate of Insurance El. With incorporation of Insurance provisions as shown,this contract is approved <br /> by the Risk Manager: <br /> Risk Manager's Signature: Date: 44) <br /> Financial Services <br /> This Contract is condi ' ned upon appropriation by the Board of Commissioners Yes No❑. 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 Budget and Fiscal Control Act: <br /> Financial Services Director's Signature: A"4.1. Ac_ Date: j <br /> County Attorney <br /> Approval by Board ❑ (Contracts $90,000.00 r 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 b en eviewed pproved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: /—/6 <br /> County Manager <br /> This contract has been reviewed and is ap rove y the County Manager Yes To❑. <br /> This contract has been reviewed a s f si r by the air s❑No❑. <br /> 4-W <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 />