2012-109 EMS - Ashley McCaskill for Paramedic Academy Program

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d� loot ,J�o ORANGE COUNTY CONTRACT CONTROL SHEET Routing Order: (1) Department, (2) IT, (3) Risk Management, (4) Financial Services, (5) Attorney, (6) Manager, (7) Clerk This Document shall accompany all contracts and shall be submitted for signature in the Routing Order specified above. If the Manager determines the contract is not appropriate for Manager approval the Manager shall submit the contract for BOCC approval. Contracts for BOCC approval must be submitted through, and complete, the routing process prior to agenda review. Contracts for legal review should be completed through the legal review process prior to being routed for signature. Department Party/Vendor Name: Multiple (See Attached Contracts) Party/Vendor Contact Person: Kim Woodward Contact Phone: 919- 245 -6133 Party/Vendor Address: PO Box 8181 City Hillsborough State: NC Zip: 27278 Department: Emergency Services Amount: N/A Purpose: To fund training time for Paramedics and to ensure that the time is returned via years of service Budget Code(s): N/A Vendor # N/A (N /A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date Approved by Board Yes❑ No® Agenda Date: Title of Contract: Paramedic Academy Training Agreement If this is a Grant Agreement, pre - application has been approved by the Board of Commissioners Yes❑ No❑. If submitted for bid were bids/RFPs received Yes❑ No❑ Bid/RFP number This contract has been reviewed and approved by the Department Director as to technical content: Department Director's Signature: Date: 7i IT Director (Applicable only to hardware /software purchases or related services) This contract has been reviewed and approved by the Information Technology Director as to technical content and information technology specifications: IT Director's Signature: Date: Risk Management Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required Hold Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as shown, this contract is approved by the Risk Manager: Risk Manager's lSi nature: C/ Date: S' 7- I tv,ee (v �Y� }mil oZ 3 m,u Financial Services This Contract is condition on appropriation by the Board of Commissioners Yes ❑No A budget amendment is necessary before approval Yes❑ No[�If budget amendment is necessary, please attach to this form. is instrument has been pre - audited in the manner required by the Local Government Bud eta11��nd Fiscal Col // g Financial Services Director's Signature: (�(, Date: I t L �IKZ County Attorney Approval by Board ❑ (Contracts $90,000.00 or more for goods or services, $250,000.00 or more for construction, or any BOCC consultant contract). Approv by Ma ager ❑ (Most other contracts $1,000 and above). Department Director approval only ❑ (Under $1,000). This contract has n evi and approved by the Attorney as to legal form and sufficie cy: I Attorney's Signature Date. Jr-� County Manager This contract has been reviewed and is approve the County Manager Y No❑. This contract has been reviewed ands for sign4ue by the Chair Yes❑NoQ--_ Manager's Signature: Date: 2 �/ Clerk to the Board Approved by BOCC on the _ day of , 20 . Submitted for Chair signature on the _ day of , 20. Clerk's Signature: Revised March 2012 Date: