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CAEARRUS COUNTY - CONTRACT CONTROL SHEET <br />Routing Order. (1) Originating Department, (2) Contract Administrator, (3) County Attorney, (4) Return to Contract Admin <br />ORIGINATING DEPARTMENT /'1 -� 'tit: L ce'__.. <br />(THIS IS THE ONLY SECTION TO BE COMPLETED BY ORIGINATING DEPARTMENT) <br />ContractorNendor: US Dept. of Agriculture Vendor Number: 4 4 3t-( <br />Purpose: Supplemental Lease Agreement for space @ 715 Cabarrus Ave W. <br />Amount: $31242.48 <br />Account # budgeted: Revenue <br />Department Number: 1710 Dept. Rep.: <br />TYPE OF CONTRACT (Please check one) ❑ New 0 Renewal Effective Date: 07/01/2008 <br />Expiration Date: 06/30/2009 <br />Checklist Insurance Cerfifrcate(s) Requested <br />® County Policy Review ❑ General Liability Insurance <br />❑ Vendor W -9 ❑ Automobile Liability Insurance <br />❑ Worker's Camp Insurance <br />Originals /Copies to be Distributed <br />❑X Original /copies to Vendor ❑ Other Routing Instructions <br />❑ Copies to originating Department <br />U Electronic Form contract submitted to Contract Administrator <br />Department Head Signature .(}l y , � Date: 05/28/2008 <br />Signature above verifies this document has been reviewed and approved by the Department Head. <br />INFORMATION TECHNOLOGY DIRECTOR <br />(Applicable only for hardware /software purchase or related services) <br />This document has been reviewed and approved by the Information Systems Director as to technical content. <br />IT Director's Signature: f fit_ Date: <br />CONTRACT ADMINISTRATOR !! <br />Date Received: 03/20/2008 Contract Control #: l <br />Sufficient funds are available in the proper account to pay for this expenditure. Yes ❑ No ❑ A <br />A budget amendment is necessary before this agreement is approved. Yes ❑ No ❑ +r <br />A budget amendment is attached as required for approval of this agreement. Yes ❑ No ❑ <br />Does this contract require Board of Commissioners action? Yes ❑ No ® Date of action: <br />Does (his contract require County Manager action? Yes X No ❑ Date of action: <br />Pre -audit certification completed. ❑❑ Non - appropriation clause included for multi -year contracts. <br />Contract Administrator's Signature: C;�Y LL t ! l'.l . L �L. ts:L�I" Date: 05/28/2008 <br />COUNTY ATTO ' 1 � 1 I <br />This document has been reviewed and approved by the Coun Attorney in rely <br />County Attorney's Signature: r.lx s ,s t it <br />rike fl) <br />\ AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA. <br />Completed and Filed by Contract Administrator. <br />C <br />al4niteni V' Y AL <br />0, 5 0 <br />Date: Attach num <br />