Orange County NC Website
Browse       Search
�o/A - mM� . <br /> � ` ` ~� <br /> ORANGE COUNTY—CONTRACT CONTROL SHEET �� <br /> Routing Order: (l)Doparm�cut.(2)IT,(3)Risk��anu8cmeru.(4)Financial Services,(5)'�uoruoy.(6)0�uuug (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: Person County PartyNendor Contact Person: Janet Clayton Contact Phone: 336 597 2204 Pu,tyNcndo,Add,coe: <br /> 355-A South Madison Blvd. Roxboro,NC City Roxboro State:nc Zip: 27573 Department: Health Amount: 36.000 Purpose: <br /> Bioterrorism Coordinator Budget Code(s): 10414020 630000 Vendor#24Z45 /A if new vendor) Vendor is a BOCC consultant? <br /> Yes o0 Contract Type: (Check one)New Fl Renewal Amendment 0 Effective Date 7/l/20l2 Approved by Board Yes <br /> ENoZ Agenda Date: Title of Contract: <br /> If this is a Grant Agreement, pre-application has been approved by the Board of Commissioners Yco0No0. If submitted for bid were <br /> 6ido/QF9s received`yeo[ly4o[l 8id/BFPoumber This contrac has been reviewed and approved by the Department Director as to <br /> technical content: <br /> - �g <br /> L� � �� ����� <br /> l�epartmuwnt|�ireuu/r,oSignature: «��e�-~_- Date: -, - _° — ~—`� c_~_- <br /> ITlNiceuxwr <br /> (Applicable only to6uruwure6oftvure purchases vr related xervicox)7bi0000truutbuoboeorovimvcdanduppnvvcdhyd`olnfonuxLioo <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; 0 Professional; [l Property; OR No Insurance Required R-..- Hold <br /> Contract pending receipt of Certificate of Insurance LI. With incorporation of Insurance provisions as shown, this contrac is approved <br /> by the Risk Manager: <br /> Risk Manager's Signature: <br /> ~ /).Am __ W Date: 1 '74 ' /z.~~ ,<�^'�� <br /> u� = �� ~��../i '�J �x'' {��v«� .` � - /2�^~� /"i,y^r�'i^z`^k„,f - z+^~xe <br /> - Financial Services _Zmm~rA PA' <br /> This Contract is cnnddi appropriation by the Board [Commissioners Yeu0YoX� A budget amendment is necessary <br /> hebzn:uppvwvullco0 <br /> 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 Act: <br /> Financial Services Director's Signature: W4/14 A /)4,..-� - Date: 1-1(24' 12' <br /> County Attorney <br /> Approval F $ more for goods or services, $250.800.00 or more for construction, or any <br /> BOCC <br /> consultant contract). Appro by (Most other $1,000 and above). Department Di rectorapp,ovu l only 0 (Under <br /> $}.000). Thiouoo�uc/buo <br /> evie ed d approved byd,nAuonoeyuoto \egu\toonuuduufb <br /> , � <br /> Attorney's Signature Date: Lt AD� �^� <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager YceErNoLJ. <br /> This contract has been reviewed and is for si aturcbyt"cChair yox0lNo2.- <br /> � / I �� <br /> Manager's Signature: Q� ~ ' �� Date: ° ~ | — >2-^~ <br /> Clerk to the Board <br /> Approved by BOCC on the day of A1 I S 4mitted for Chair signature on the day of ,20 . <br /> ' - Date: —/ / �V <br /> Clerk's Signature: / / � ' -`''r' _2 <br /> Revised March 2012 <br />