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CONTRACT COVERSHEET <br />NOTE: Shaded areas are for County Executive review. <br />DEPARTMENT <br />CONTRACT/ADDENDUM #: <br />Planning & Development <br />I �:� kLf <br />1. This contract, grant or addendum: (J AWARDS ❑ ACCEPTS <br />Contract Addendum <br />If Addendum, please include <br />original contract number <br />j <br />2. This contract is discretionary ❑ YES ❑ NO <br />POS <br />❑ <br />El Co Lesse <br />L)3. <br />Term of Contractor Addendum: From: 3-3-2015 To: 5-30-2015 <br />❑ Co Lessor <br />❑ Intergovernmental <br />0 <br />❑ <br />4. Amount of Contractor Addendum4,950 <br />--- <br />❑ Purchase of Property <br />❑ Property Sale <br />5. Purpose: <br />Provide expert advice and insurance policy review services to the <br />❑ <br />county Zoning & Land Regulation Committee <br />Other: <br />❑ <br />6. Vendor or Funding Source -.American Risk Management Resources Network, LLC <br />7. MUNIS Vendor Code: ~ S c <br />8. Bid/RFP Number: <br />9. If grant: Funds Positions? ❑ YES ❑ 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. PDZNGLR32274 <br />Amount $ 4,950 <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 requi mentppapply? ❑ YES ❑ NO <br />14. Director's Approval o • a✓�•c <br />CONTRACT REVIEW/APPROVALS <br />Initials Ftnt Date In Date Out <br />Received �S `� 1 <br />ontroller 3 � <br />! Corporation Counsel <br />�L Risk Management <br />ADA Coordinator 3/3 I i 3 31 S <br />0 P3 Purchasing Agent �' tS 3 3 1ST <br />7 County Executive <br />Footnotes: <br />VENDOR <br />Vendor Name & Address <br />ARMR Network <br />7780 Elmwood Ave. Suite 130 <br />Middleton, WI 53562-5407 <br />Contact Person <br />David Dybdahl <br />Phone No. <br />608-836-9567 <br />E-mail Address <br />dybdahl@armr.net <br />Return To: Name/Title: Majid Allan, Senior Planner Dept.: Planning & Development <br />Phone: 608-267-2536 Mail Address: Room 116 CCB <br />E-mail: allan@countyofdane.com <br />012-47 (2/13) <br />