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ORANGE COUNT'-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: Penta Engineering Group,Inc. Party/Vendor Contact Person: Rick Welsch Contact Phone: 678-282-1999 <br /> Party/Vendor Address:267 Timber Drive City Garner State:NC Zip:27529 Department:Asset Management Services Amount: <br /> 1950.00 Purpose: Survey for Asbestos-containing materials at the R.E.Whitted Building "A"-300 W.Tryon Street,Hillsborough,NC <br /> 27278 Budget Code(s):61370035-87J000-10028 Vendor#61470 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® <br /> Contract Type: (Check one)New® Renewal ❑ Amendment ❑ Effective Date February 3,2013 Approved by Board Yes❑No❑ <br /> Agenda Date: Title of Contract:Whiffed-Asbestos <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 This contract has been reviewed and approved by the Department Director as to <br /> technical content: <br /> Department Director's Signature: "-----Date: <br /> IT D ect r <br /> (Applicable only to hardware/software purchases or related services) is contract has been reviewed and approved by the Information <br /> Technology Director as to technical content and information techn 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 E]. With incorporation of Insurance provisions as shown,this contract is approved <br /> by the Risk Manager: D � g N 0 T <br /> Risk Manager's Signature: , w.r Date: U <br /> FEB - 4 2013 <br /> yFinancial Services Rer_: - <br /> This Contract is conditioned Won appropriation by the Board of Commissioners Yes❑Noy A b t amendment is necessa <br /> before approval Yes[]NoIf budget amendment is necessary,please attach to this form. This instrume <br /> manner required by the Local Government Budget�and�Fiscal Control ct: �f- <br /> Financial Services Director's Signature: (Y�-L✓ r'd'� Date: <br /> z17 <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 been reviewe and pprov he Attorney as to legal form and sufficiency: <br /> Attorney's Signature '"� Dater <br /> County Manager <br /> This contract has been reviewed an is appro by the C unty Manager Yes No❑. <br /> This contract has been reviewe d i r i ture b e C Y ❑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 />