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, ,,/,4 /6' <br /> ORANGE COUNTY—CONTRACT CONTROL SHEET <br /> Routing Order: (l)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 /> Party/Vendor Name: Charles House Association Party/Vendor Contact Person: Puu|K\cvcr Contact Phone: PurtyNcudor <br /> Address: 109 Hillcrest Ave. City Carrboro State:NC Zip: 27510 Department: Aging Amount: $3,000.00 Purpose: Community Respite <br /> Services for A iu Transitions Budget Code(s): 10432020-630102 \/cndor# }V446 (N/A if new vendor) Vendor is a BOCC <br /> consultant? Yes oFl Contract Type: (Check one)New fl Renewal[Z] Amendment 0 Effective Date U7/Ol/2O)2 Approved by <br /> Board Yev0No0 Agenda Date: Title of Contract: <br /> If this is a Grant Agreement,pre-application has been approved by the Board of Commissioners Ycx0 No0. If submitted for bid were <br /> bida/KFPo received TesFlNu0 Bid/RFP number This contract has been reviewed and approved by the Department Director as to <br /> technical content: <br /> 8�epu,tmuemt|Nir*cumr"oSignature: C)a...i.i.... - _� D�c: L«/�[a/ /�_'' � 1 �- ' ' <br /> IT Director <br /> (Applicable only to 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: Date: <br /> Risk Management <br /> Include the following coverages: 0 CGL; 0 Auto; Fl WC; g~irob:smionu|; 0 Property; OR No Insurance Required 0. Hold <br /> Contract pending receipt of Certificate of Insurance LI. With incorporation of Insurance provisions as shown, this contract is approved <br /> by the Risk Manager: <br /> Risk MmomKwr`uSkAumtmrw: <br /> ---P / � �' ' u� Date: y~ ��P'/�� <br /> ^� /�-� <br /> /^�.��� uv��//JL <br /> Financial Services <br /> This is dii appropriation by the Board of C i i Yeu0N A budget amendment is necessary <br /> before approval Yen|| If budget amendment is necessary,please attach to this form. hi. instrument has been pre-audited in the <br /> manner required by the Local Government Budget and Fiscal C l Act: <br /> Financial 8orviceo|�irectwr,mSignature: �4 �m�~�~� ��. Jk1__— Date ')- <br /> � <br /> ~p.e��. ��)��, � , <br /> County Attorney <br /> Approval by Board [l (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 Manag st other contracts$1,000 and above). Department Director approval only El (Under <br /> $1,000). This contract h bee viewed uoduppnuvedhydhc/\uocucyaxu, |cgu| 1oonundxufficicuuy: <br /> � <br /> Attorney's Signature Date: «/= �«-~ <br /> ~ County Manager <br /> This contract has been reviewed and is approved by the County Manager YegrfNoFl. <br /> This contract has been reviewed and is for ' uuu A.y t 2,uir },es0Nog! <br /> I � � ����moogmr^oSigoatnre� ' ° -�� Date: <br /> � ' � -- <br /> Signature: 11. <br /> Clerk to the Board <br /> f\pp,ovudhyB0CC"od`cdoyof . 20 . Submitted for Chair signature on the day of . 20 . <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />