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21.D1=.?-19,C <br /> ORANGE COUNTY-CONTRACT CONTROL SHEET <br /> Routing Order: (1)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: Senior Care of Orange County, Inc PartyNendor Contact Person: Alvonia Baldwin Contact Phone: 919-245-2017 <br /> Party/Vendor Address: PO Box 8181 City Hillsborough State: NC Zip:27278 Department: DSS Amount: not to exceed$20,000 <br /> Purpose: Adult Day Health Services Budget Code(s): 10400220-630000 Vendor# (N/A if new vendor) Vendor is a BOCC <br /> consultant? Yes❑Nor] Contract Type: (Check one)New❑ Renewal ® Amendment El Effective Date 07/01/12 Approved by <br /> Board Yes❑No❑ Agenda Date: 06/15/12 Title of Contract: Senior Care of Orange County,Inc <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: /, : _ - /�A Date: 014-o1-{"1y <br /> IT Director <br /> (Applicable only to hardware/software purchases o relate services)This contract has been reviewed and approved by the Information <br /> Technology Director as to technical content and info ion technology specifications: <br /> IT Director's Signature: Date: <br /> ask Ma Bement <br /> Include the following coverages: [ CGL; E f Auto; WC; Professional; ❑ Property; OR No Insurance Required ❑. Hold <br /> Contract pending receipt of Certificate of Insurance 5 With incorporation of Insurance provisions as shown, this contract is approved <br /> by the Risk Manager: <br /> Risk Manager's Signature: 44...c... / Date: 71/112 <br /> Financial Services <br /> This Contract is conditioned on 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. This instrument has been pre-audited in the <br /> manner required by the Local Government Budget and Fiscal Control Ac <br /> Financial Services Director's Signature: a"4,-4,—. <br /> /�' • .(/"- Date: 7(2114- <br /> g <br /> [Pi Z5;11 i County Attorney <br /> Approval by Board ❑ (Contracts $90,000.0 or more for goods or services, $250,000.00 or more for construction, or any BOCC <br /> consultant contract). Approva by Manager (Most other contracts$1,000 and above). Department Director approval only ❑ (Under <br /> $1,000). This contract has be eviewed d a proved by the Attorney as to legal form and suffici cy: <br /> Attorney's Signature Date: I -- <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager YeseNo❑. <br /> This contract has been reviewed and is for sig :ie b the ha' Yes❑No[�. <br /> Manager's Signature: I I / / Date: 7 et—/ <br /> lerk to the Board <br /> Approved by BOCC on the day of ,20 . Submitted for Chair signature on the day of ,20 . <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />