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iota—gyp{. <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: Information,Inc Party/Vendor Contact Person: Michael Bradley Contact Phone: 919-545-0246 Party/Vendor <br /> Address: PO Box 1306 City Carrboro State:NC Zip:27510 Department: DSS Amount:not to exceed$975.00 Purpose:NC DAysheet <br /> Automation Budget Code(s): Vendor# (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No❑ Contract <br /> Type:(Check one)New® Renewal❑ Amendment ❑ Effective Date 06/01/12 Approved by Board YesigNo4 Agenda Date: <br /> Title of 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: ‘11‘ Date: 0 i-D3"I <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: Date: <br /> Risk Management <br /> Include the following coverages: El CGL; El Auto; ❑ WC; ❑ Professional; El Property; OR No Insurance Required . Hold <br /> Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as shown,this contract is approved <br /> by the Risk Manager: <br /> Risk Manager's Signature: etaeviA4A/ L) 2 r� Jib!Date: l 1 L. <br /> Financial Services <br /> This Contract is conditions upon appropriation by the Board of Commissioners Yes❑No . A budget amendment is necessary <br /> before approval Yes❑NoM 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: VlW -'•I i• Date: 1(0( 1 (2.-- <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 :OCC <br /> consultant contract). Approval by Manager❑ (Most other contracts$1,000 and above). Department Director approval only A (Under <br /> $1,000). This contract has been re - ed an. . p ved by the Attorney as to legal form and suffici cy: <br /> --�Attorneys Signature �,i If. <br /> ' Date: t l <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Yes No❑. <br /> This contract has been reviewed and is for signature by the Chair Yes❑No� <br /> Manager's Signature: athq Date: 7-/ -/z-- <br /> Clerk 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 />