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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, ) 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: Francina Muse Attv Party/Vendor Contact Person: F. Muse Contact Phone: 919 742 6611 Party/Vendor Address: <br />PO Box 12611 City Durham State: NC Zip: 27709 Department: CSE Amount: $10,000 Purpose: CSE legal services Budget Code(s): <br />1044002063400 Vendor # (N /A if new vendor) Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one) <br />New ❑ Renewal ❑ Amendment ❑ Effective Date 07/01/2012 Approved by Board Yes❑ No❑ Agenda Date: Title of <br />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: Date: <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: <br />Date: <br />Risk Management <br />Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; [✓]Professional; ❑ Property; 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: iNYYI�� Date: <br />Financial Services <br />This Contract is conditioned upon appropriation by the Board of Commissioners Yes ❑No A budget amendment is necessary <br />before approval Yes❑ No If budget amendment is necessary, please attach to this form. fhis 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: �a"'�"'� -/✓, /A— Date: 3-20-12— <br />County Attorney <br />Approval by Board ❑ (Contracts $90,000.00 or more for goods or services, $250,000.00 or more for construction, or any BOCC <br />consultant contract). Approval by Managerost other contracts $1,000 and above). Department Director approval only ❑ (Under <br />$1,000). This contract has been reviewe and approved by the Attorney as to legal form and sufficiency: <br />Attorney's Signature Date: <br />County Manager <br />This contract has been reviewed and is approved by the County Manager YasrNo❑. <br />This contract has been reviewed and is for signatur&bythe Chair <br />f,2, <br />Manager's Signature: Date: c� <br />Clerk to the Board <br />Approved by BOCC on the _ day of 20 . Submitted froAr Chair signature on the day of 20 <br />Clerk's Signature: Date: <br />Revised March 2012 <br />