R 2014-117 Planning - J F Wilkerson Contracting Co for Buckhorn Mebane Utilities Phase 2 Change Order #3

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ORANGE COUNTY—CONTRACT CONTROL SHEET Routing Order: (1)Department,(2)IT,(3)Risk Management,(4)Financial Services,(5)Attorney,(6)Manager,(7)Clerk This Document shall accompany all contracts and shall be submitted for signature in the Routing Order specified above. If the Manager determines the contract is not appropriate for Manager approval the Manager shall submit the contract for BOCC approval. Contracts for BOCC approval must be submitted through,and complete,the routing process prior to agenda review. Contracts for legakeview should be completed through the legal review process prior to being routed for signatur 2ZV2, Department ( � , Party/Vendor Name: J.F.Wilkerson Contracting Company Party/Vendor Contact Person: Joseph Wilkerson Contact Phon\&91 - 7- 1829 Party/Vendor Address: 10710 Chapel Hill Rd. City Morrisville State:NC Zip:27560 Department:Planning Amount: Purpose:Buckhorn Mebane Utilities Phase 2 Change Order#3 Budget Code(s):61370035-880000-30040 Vendor#55607 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type: (Check one)New❑ Renewal❑ Amendment ® Effective Date January 14,2014 Approved by Board Yes®No❑ Agenda Date: 11/08/2012 Title of Contract:Orange County Buckhom- Mebane EDD Phase 2 Water and Sewer Improvements If this is a Grant Agreement,pre-application has been approved by the Board of Commissioners Yes❑No❑. If submitted for bid were bids/RFPs received Yes®No❑ Bid/RFP number 367-286This contract has been reviewed and approved by the Department Director as to technical content: / Department Director's Signatu , Date: IT Di ctor (Applicable only to hardware/software purchases or related servic )This contract has been reviewed and approved by the Information 1� Technology Director as to technical content and information ec ology specifications: IT Director's Signature: Date: isk Management Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required ❑. Hold Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as shown,this contract is approved by the Risk Manager: \\< Risk Manager's Signature: Date: Financial Services This Contract is condi •oned upon appropriation by the Board of Commissioners YesdNNo❑. A budget amendment is necessary before approval Yes[✓J No❑. If budget amendment is necessary,please attach to this form. This instrument has been pre-audited in the manner required by the Local Government BudF(aml_k�_n cal ControoA ll Act: Financial Services Director's Signature: Date: 111311q 1115114 County Attorney Approval by Board ❑ (Contracts $90,000.00 r more for goods or services, $250,000.00 or more for construction, or any BOCC consultant contract). Approval by Manager Most other contracts$1,000 and above). Department Director approval only❑ (Under $1,000). This contract has b en reviewed ap a roved y the Attorney as to legal form and sufficiency: Attorney's Signature -r i Date: County Manager This contract has been reviewed and is ap ved by the County Manager Yes io❑. This contract has been reviewed s fo i a e the Chair es No❑. Manager's Signature: Date: iS Clerk to the Board Approved by BOCC on the_day of ,20 Submitted for Chair signature on the_day of ,20 Clerk's Signature: Date: Revised March 2012