Orange County NC Website
Browse       Search
,�OIB - 51a <br /> RANGE 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: New Hope Fire Department Party/Vendor Contact Person: Michael Tapp Contact Phone: 919-619-8685 <br /> Party/Vendor Address:4012 Whitfield Road City Chapel Hill State:NC Zip:27516 Department:Emergency Services Amount: <br /> Purpose: Fire Protection Agreement Budget Code(s): Vendor# (N/A if new vendor) Vendor is a BOCC consultant? <br /> Yes❑No® Contract Type: (Check one)New❑ Renewal ® Amendment ❑ Effective Date Approved by Board Yes® <br /> No❑ Agenda Date: 11/19/2013 Title of Contract:Fire Protection and Emergency Services Agreement <br /> If this is a Grant Agreement,pre-application has been approved by t Board of Commissioners Yes❑No❑. If submitted for bid were <br /> bids/RFPs received Yes❑No❑ Bid/RFP n e This co ct has 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/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:Q �,. Date: / <br /> 1JlollZ <br /> Financial Services <br /> This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No[Rf A budget amendment is necessary <br /> before approval Yes❑No[Z. 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: /J <br /> Financial Services Director's Signature: ��fkG,L �� Date: -f <br /> LlNIV4 <br /> County Attorney <br /> Approval by Board)?!r(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 been vie we a proved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: °I <br /> County Manager <br /> This contract has been reviewed an is p v by the County Manager Yes2NoEl. <br /> This contract has been reviewe d i or si ature th Phair Yes❑No❑. <br /> Manager's Signature: Date: <br /> k to the a <br /> Approved by BOCC on the day of 12 i r hair signature on fhe f y of 120 <br /> Clerk's Signature: Date: 7 2 u <br /> Revised March 2012 <br />