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�014_Zc0 <br /> ORANGE COUNTY—CONTRACT CONTROL SHEET <br /> Routing Order: (1)Department,(2)IT,(3)Risk Management,(4)Financial Services,(5)Attorney,(6)Manager, ( i ( Ierk <br /> This Document shall accompany all contracts and shall be submitted for signature in the Routing Order specified above. I I the Manager <br /> determines the contract is not appropriate for Manager approval the Manager shall submit the contract for BOCC approval r otitracts for <br /> BOCC approval must be submitted through,and complete,the routing process prior to agenda review. Contracts for lega I r i C w should <br /> be completed through the legal review process prior to being routed for signature. <br /> Department <br /> Party/Vendor Name: Orange Rural Fire Department Party/Vendor Contact Person: Matt Heinze Contact Phone: 1'im,k Vendor <br /> Address: 835 Phelps Road City Hillsborough State:NC Zip:27278 Department: Orange County Emergency Services An emit: 0.00 <br /> Purpose: Use agreement of substation Budget Code(s): Vendor#50210 <br /> (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No❑ Contract Type: (Check one)New❑ Renewal❑ \mC ndment <br /> ❑ Effective Date Approved by Board Yes❑Nor-1 Agenda Date: Title of Contract: <br /> If this is a Grant Agreement,pre-application has been approved by the Board of Commissioners Yes❑No❑. If submitted loo bid were <br /> bids/RFPs received Yes❑No[:] Bid/RFP number This c act has been reviewed and approved by the Department I)irector as to <br /> technical content: <br /> Department Director's Signature: Date:/ / <br /> IT Director <br /> (Applicable only to hardware/software p rchases or related services)This contract has been reviewed and approved by tht I n forination <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 sho i gthiract i";' ''J <br /> by the Risk Manager: t J <br /> Risk Manager's Signature: L omp ,Les Date: MAY 314 <br /> Financial Services By <br /> This Contract is conditioned" on appropriation by the Board of Commissioners Yes❑No[( A budget amen nii iifi i "n <br /> before approval Yes❑NoMIf budget amendment is necessary,please attach to this form. This instrument has been prc-audited in the <br /> manner required by the Local Government Budget and Fiscal Control Act: <br /> Financial Services Director's Signature: � 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, of .iny BOCC <br /> consultant contract). Approval by Manager (Most other contracts$1,000 and above). Department Director approval on l, ❑ (Under <br /> $1,000). This contract has bee iew approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: ► �" <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Yes[ No❑. <br /> This contract has been reviewed and is for si ure b the 9air Yes❑No❑. <br /> Manager's Signature: 'y '� if Date: <br /> 1 <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 />