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20/2- <br /> 2p12--( SC 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 /> (111.Adtif2e. Department <br /> Party/Vendor Name: Fit Feet Nurses Party/Vendor Contact Person: see attached Contact Phone: Party/Vendor Address: <br /> City State: Zip: Department:Aging Amount: $4,500.00 Purpose: clinic Budget Code(s): 29430320-622000 <br /> Vendor# (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No Contract Type: (Check one)New❑ Renewal <br /> ® Amendment ❑ Effective Date 07/01/2012 Approved by Board Yes❑No Agenda Date: 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❑Nor] Bid/RFP number This contract has been reviewed and approved by the Department Director as to <br /> technical content: AA <br /> Department Director's Signature: ..-f. Date: 6 /'f /Z. <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: ❑ CGL; ❑ Auto; ❑ WC; 1 1- rrofessional; ❑ Property; OR No Insurance Required D. 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. Date: 6.;/ */v <br /> r w &/ 61/1 <br /> Financial Services <br /> This Contract is conditioned pon appropriation by the Board of Commissioners Yes❑No A budget amendment is necessary <br /> before approval YesEl No . If budget amendment is necessary,please attach to this form. Thi instrument has been pre-audited in the <br /> manner required by the Local Government Budget a and Fiscal Control Act:Financial Services Director's Signature: ) Date: 4271 I Z <br /> -: ce . . 19Izca <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 BOCC <br /> consultant contract). Approval by Manager M (Most other contracts$1,000 and above). Department Director approval only El (Under <br /> $1,000). This contract has been e iewed and approved by the Attorney as to legal form and sufficiency: <br /> i �23 <br /> Attorney's Signature Date: O 7/ //R, <br /> 11o/.1)1n16, X12- '53 . 7/ ,-co/ REc.D. <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Yes21Qo❑. <br /> This contract has been reviewed and is for signature by the • air Yes❑No <br /> Manager's Signature: I Date: <br /> 7 z 3 / <br /> i <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 />