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4 <br />CONTRACT COVERSHEET T I �� C <br />NOTE: Shaded areas are for County Executive revie 1, MAY 0 7 2009 <br />DEPARTMENT <br />CONTRAC <br />/ADDEtCUl M #' - <br />Received <br />Planning and Development <br />9475L1'-'1_"_ <br />Corporation Counsel <br />1. This contract, grant or addendum: ❑ AWARDS ❑ ACCEPTS <br />Contract Addendum <br />ADA Coordinator <br />014 �- <br />If Addendum, please include <br />original contract number <br />003 <br />Executive <br />2. This contract is discretionary 0 YES NO <br />ClPOS <br />❑ Co Lesse <br />❑ <br />❑ <br />3. Term of Contract or Addendum: From: 6-30-08 To: 12-31-09 <br />I❑ Co Lessor <br />❑ <br />4. Amount of Contract or Addendum $18,000 <br />❑ Intergovernmental <br />❑ <br />❑ Purchase of Property <br />5. Purpose: <br />C1 Property Sale <br />Modifies contract end date and billing schedule. (See revised <br />® Other; <br />❑ <br />Schedules A & B, attached.) <br />6. Vendor or Funding Source: Town of Primrose <br />7. MUNIS Vendor Code: 8024 <br />8. Bid/RFP Number: <br />9. If grant: Funds Positions? ❑ YES O NO Will require on-going or matching funds? ❑ YES ❑ NO <br />10. Are funds included in the budget? ❑ YES ® NO <br />11. Account No. & Amount, Org. & Obj. 538 6205 2925 qz,4 (,2_ <br />Amount $.18,000.00 <br />Account No. & Amount, Org. & Obj. <br />Amount $ <br />Account No. & Amount, Org. & Obj. <br />Amount $ <br />12. Is a resolution needed: ❑ YES ❑ NO If "YES," please attach a copy of <br />the Resolution. <br />If Resolution has already been approved by the County Board, Resolution No. & <br />date of adoption <br />13. Does Domestic Partner equal benefits requirement apply? ❑ YES ❑ NO <br />14. Director's Approval t <br />CONTRACT REVIEW/APPROVALS <br />Initials <br />Date Out <br />s%z/o9 <br />Received <br />772E—Controller <br />L4 -C9 <br />Corporation Counsel <br />Risk Management <br />ADA Coordinator <br />014 �- <br />Purchasing Agent <br />003 <br />Executive <br />Footnotes: <br />1, <br />1•a <br />Ftnt Date In <br />-1q <br />Date Out <br />s%z/o9 <br />rr 119 <br />L4 -C9 <br />VENDOR <br />Vendor Name & Address <br />Town of Primrose <br />Contact Person <br />Dale Judd/Winnie Losenegger <br />Phone No. <br />608-832-6213/832-4471 <br />E-mail Address <br />twprim@chorus.net <br />Return To: Name/Title: Todd Violante Dept.: Planning and Development <br />Phone: 266-4021 Mail Address: Room 116, CCB <br />E-mail: violante@co.dane.wi.us <br />012-47 (11108) <br />