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,�C)14- 7 <br /> 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: Pilot Environmental,Inc. Party/Vendor Contact Person: BradleyLuckey Contact Phone: 336-708-4997 <br /> Party/Vendor Address:P.O.Box 128 City Kernersville State:NC Zip:27278 Department:Planning Amount: $31,650 Purpose: <br /> Environmental Services Budget Code(s): 10620020-630000 Vendor#N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes <br /> ❑No® Contract Type:(Check one)New® Renewal❑ Amendment ❑ Effective Date May 15,2014 Approved by Board Yes <br /> ❑No® Agenda Date:N/A Title of Contract: Services Agreement Under$90,000 <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 N/AThis contract has been reviewed and approved by the Department Director as to <br /> technical content: <br /> Department Director's Signatu <br /> X, <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; El Property; OR No it, d F1 H d <br /> Contract pending receipt of Certificate of Insurance E. With incorporation of Insurance provisions as s1 1' cKat#ta a�p d <br /> by the Risk Manager: <br /> g g (� Date: 5 j ' MAY — 5 2014 <br /> Risk Manager's s Si nature: <br /> s1S <br /> Financial Services By <br /> This Contract is conditioned upon appropriation by the Board of Commissioners Yes❑No®. A budget amendment is necessary <br /> before approval Yes❑No®. 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 Co n rol Act: <br /> Financial Services Director's Signature: l `" —5141 51� Date: / <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 r iewed ved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: S �� <br /> County Manager <br /> This contract has been reviewed and is appro by the County Manager Yes , <br /> This contract has been reviewed and is or s' t by th C a' es ®. <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 />