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ORANGE COUNTY—CONTRACT CONTROL SHEET <br /> Routing Order: (I)Department,(2)IT,(3)Risk Management,(4)Financial Services,(5)Attorney,(6)Manager,(7)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 /> PartyNendor Name: Andrew Wagoner Party/Vendor Contact Person: Andrew Wagoner Contact Phone:336-562-8007 PartyNendor <br /> Address:308 Dave Smith Road City Prospect Hill State:NC Zip:27314 Department:DEAPR Amount:$3900.00 Purpose: <br /> Tae-Kwon-Do Budget Code(s):630000 Vendor II 56749 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No <br /> Contract Type:(Check one)New® Renewal❑ Amendment ❑ Effective Date April 1,2012 Approved by Board Yes❑No <br /> Agenda Date: Title of Contract:Martial Arts Instruction <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: C <br /> Department Director's Signature: v Date: /12 <br /> � 3l 2,1 /1 <br /> IT Director <br /> (Applicable only to/rardware/sofware purchases or related services)This contract has been reviewed and approved by the Information <br /> Teclmology Director as to technical content and information technology specifications: <br /> IT Director's Signature: Date: <br /> Risk Management <br /> Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; 0 Property; [rOR No Insurance Required 0. Hold <br /> Contract pending receipt of Certificate of Insurance 0. With incorporation of Insurance provisions as shown, this contract is approved <br /> by the Risk Manager: r <br /> Risk Manager's Signature: �-id 1 s{ {J Date: e 'Z •/v <br /> i G 07 0/2- of C'��J <br /> Financial Services <br /> This Contract is condition pon 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. his instrument has been pre-audited in the <br /> manner required by the Local overnment Budget d Fiscal Control A t: <br /> Financial Services Director's Signature: 0./v414-.1••/ Date: Z <br /> County Attorney <br /> Approval by Board ❑ (Contracts over $90,000.00 for goods or services, $250,000.00 for construction, or any BOCC consultant <br /> contract). Approval by Manager p (All other contracts). This contract has been reviewed and approved by the Attorney as to legal <br /> form and sufficiency: <br /> Attorney's Signature Date: /5-42. <br /> . r <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Y ,s2''to❑• <br /> This contract has been reviewed and is to be submitted for BO onsideration Yes❑No0! <br /> Manager's Signature: Date: 4- ( � <br /> Clerk to the Board <br /> Approved by BOCC on the day of ,20 . Submitted for • signat e on the , •ay of ,20 . <br /> •Clerk's Signature: / I' '• ii , / L <br /> F <br /> Revised April 2010 <br />