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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 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: H.M.Kern Corporation Party/Vendor Contact Person: Bev Andrews,Contract Administrator Contact Phone: 336- <br /> 668-3213 Party/Vendor Address: PO Box 19424 City Greensboro State:NC Zip:27419 Department: AMS Amount: $763,800 <br /> Purpose:Health Renovations @ Whitted Building Budget Code(s): 30012—Medicaid Maximization Vendor#N/A (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes❑No❑ Contract Type: (Check one)New® Renewal❑ Amendment ❑ Effective Date <br /> 2/16/11 Approved by Board Yes❑No❑ Agenda Date:2/15/2011 Title of Contract: <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: ymmq�:A D ate: 2 <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; ❑'Xuto; [TWC; ❑ Professional; aProperty; ❑ 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: <br /> Risk Manager's Signature: FiG• Date: <br /> Financial Services <br /> This Contract is conditioned pon appropriation by the Board of Commissioners Yes❑Now- A budget amendment is necessary <br /> before approval Yes❑No[4.. 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: f 1 r <br /> County Attorney <br /> Approval by Board FT(Contracts over $90,000.00 for goods or services, $250,000.00 for construction, or any BOCC consultant <br /> contract). Approval by Manager ❑ (All other contracts). This contract has been reviewed and approved by the Attorney as to legal <br /> form and sufficiency: <br /> Attorneys 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 t be submitted f BOCC consideration Yes❑No❑. <br /> Manager's Signature: <br /> Clerk to the Board <br /> Approved by BOCC on the day of 0 Su�miged for hair signa re on the day of 520 <br /> Clerk's Signature: D e: <br /> Vu oo� <br /> Revised April 2010 <br /> OL WA <br /> C <br />