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A <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: Middle School After School Program(CIS) PartyNendor Contact Person: Sheila D. Sholes-Ross Contact Phone: <br /> 919-967-6677 PartyNendor Address: 151 East Rosemary Street,Suite 207,PO Box 9454 City Chapel Hill State:NC Zip:27514 <br /> Department:Outside Agency Amount:$57,000 Purpose:Outside Agency Budget Code(s): 10495050-710036 Vendor#50710 (N/A if <br /> new vendor) Vendor is a BOCC consultant? Yes❑No Contract Type: (Check one)New® Renewal ❑ Amendment ❑ <br /> Effective Date 07/01/2012 Approved by Board Yes®No❑ Agenda Date:06/19/2012 Title of Contract:2012-13 Outside Agency <br /> Performance Agreement <br /> If this is a Grant Agreement,pre-application has been ap• oved by the Board of Commissioners Yes❑No❑. If submitted for bid were <br /> bids/RFPs received Yes❑NoE Bid/RFP number This contract has been reviewed and approved by the Department Director as to <br /> technical content: <br /> A11-11 r <br /> Department Director's Signature: � Date:7 — 3 —1 2 <br /> Dir: tor <br /> (Applicable only to hardware/software purchases or related services) • cont t 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: [ CGL; R'Auto; WC; [✓Professional; ❑ Property; ❑ OR No Insurance Required O. 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: 644.44, i'' 2i2_ Date: "!n <br /> [ (Z <br /> Financial Services <br /> This Contract is conditioned upon appropriation by the Board of Commissioners Yes❑No[( A budget amendment is necessary <br /> before approval Yes❑ No Y. 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 Con of Act. <br /> Financial Services Director's Signature: t"" , 1 Date: 1L !2-- <br /> "l <br /> County Attorney <br /> Approval by Board Yf (Contracts over $90,000.00 for goods or services, $250,000.00 for construction, or any BOCC consultant <br /> contract). Approval by M. . er ❑ (All other contracts). This contract has been reviewed and approved by the Attorney as to legal <br /> form and sufficiency: <br /> li� <br /> Attorney's Signature / Ali Date: 7 l'3 ID_ <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Yee:I-No❑. <br /> This contract has been reviewed and is to be submitted for BOCC consideration Yes1o❑. <br /> Manager's Signature: j% j I `Date: ? —/CP -/ ?' <br /> Clerk toy le Board <br /> Approved by BOCC on the day of -,21 iilF(.mitred for CPI gnature on _..y of ,20 <br /> Clerk's Signature: + Date: <br /> Revised April 2010 <br />