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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 con view. Contracts for legal review should <br /> tract for BOCC approval. Contracts for <br /> BOCC approval must be submitted through,and complete,the routing process prior to agenda re <br /> be completed through the legal review process prior to being routed for signature. <br /> Department <br /> Party/Vendor Name: Cedar Grove Fire De artment Party/Vendor Contact Person: Jeff Borland Contact Phone:919-619-2566 <br /> Party/Vendor Address: 720 Hawkins Road City Cedar Grove State:NC Zip:27231 Department:Emergency Services Amount: <br /> Purpose:Fire Protection Agreemen t Budget Code(s): Vendor# <br /> Yes[I No® Contract Type:(Check one)New El Renewal (N/A if new vendor) Vendor is a BOCC consultant? <br /> ® Amendment ❑ Effective Date Approved by Board Yes® <br /> No❑ Agenda Date: 11/19/2013 Title of Contract:Fire Protection and EmergengE 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❑No❑ Bid/RFP nu er Thi ontract has been reviewed and approved by the Department Director as to <br /> technical content: <br /> Ct�lellt DireCtor's Signature; Date: 1'Y <br /> DGpa <br /> IF Director <br /> (Applicahle 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: (S D 9, ( n fV7 T <br /> Risk Manager's Signature: � �� � — Date: <br /> /� FEB 11 203 <br /> 211 <br /> Financial Services <br /> This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No� A b t amendment is necessarl <br /> before approval Yes❑NoM.If budget amendment is necessary,please attach to this form. This instrumen as ee <br /> manner required by the Local Government Budget and Fiscal Control Act: <br /> Financial Services Director's Signature: • Date: <br /> —z11 L <br /> County Attorney <br /> Approval by Board 2-1('C'ontracts $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 reviewed and approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature <br /> County Manager <br /> This contract has been reviewed is pro by the Coun Manager Yes No❑. <br /> This contract has been reviewe d is r s'g at th air s❑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 />