Orange County NC Website
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: Eno Fire Department Party/Vendor Contact Person: Bryan Baker Contact Phone: 919-383-5967 Party/Vendor <br /> Address: 5019 U.S.Highway 70 West City Durham State:NC Zip:27705 Department: Emergency Services Amount: Purpose: <br /> Fire Protection Agreement Budget Code(s): Vendor# (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No <br /> ® Contract Type:(Check one)New❑ Renewal® Amendment ❑ Effective Date Approved by Board Yes®No❑ <br /> 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 the Board of Commissioners Yes❑No❑. If submitted for bid were <br /> bids/RFPs received Yes❑Non Bid/RFP num T tract 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/software purchases 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: L ti�� ���.� ■� Date: Z S <br /> tl t 8 w�vJ•;.��o— QTR <br /> Financial Services <br /> This Contract is conditioned on appropriation by the Board of Commissioners Yes❑Nov A budget amendment is necessary <br /> before approval Yes[:]No V. 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: Date: 2 S /V <br /> zl5 <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 been revie and approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date:12—(I/-/f <br /> County Manager <br /> This contract has been reviewed and i a rov y the Coun Manager Yes�To❑. <br /> This contract has been reviewed is sin ure b the it e ❑No❑. <br /> Manager's Signature: Date: l <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 />