Orange County NC Website
Browse       Search
- .~ <br /> ,ja,k1 <br /> ORANGE K�K�NTROL SHEET <br /> Routing Order: (1)D t,(2)l][(3)R6okMuougemout,(4)FiouooialServiceo'(5)Attorney.(6)Mymugnr (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: Vibeke Talley Party/Vendor Contact Person: same Contact Phone: PuctyNcudor&ddrosu: 134 E Tryon <br /> Street City Hillsborough State:NC Zip:27278 Department:Aging Amount: $1,400.00 Purpose: Occupational Therapy Services <br /> Budget Code(s): 10432020-630103 Vendor#398 if new vendor) Vendor is a BOCC consultant? Yes No Contract <br /> Type: (Check one)New[E] Renewal El Amendment 0 Effective Date O7/l6/2Ol2 Approved by Board Ycv||No Agenda <br /> Date: Title of Contract: Eldercare-OT Provider <br /> If this is a Grant Agreement, pre-application has been approved by the Board of Commissioners Yoo0No0. If submitted for bid were <br /> bido/REPo received YcoFlNo[l Bid/RFpoumber This contract has been reviewed and approved by the Department Director as to <br /> technical content: <br /> Department Director's Signature: xy Date: 7-11-12 <br /> IT Director <br /> (Applicable only m6on6vu,u/softvunc purchases or related services)This contract has been reviewed and approved hy 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; 0 Auto; LlwC; El Professional; Property; OR No Insurance Required Hold <br /> Contract pending receipt of Certificate of Insurance 0. With incorporation of Insurance provisions as shown, this contract is approved <br /> by the Risk Manager: <br /> Risk � <br /> �o& ��mmm�o�`oS��mm�mme� ' Date: +�/��//111 <br /> ~111')//e_ <br /> Financial Services <br /> This Contract is conditionecon appropriation hydhcBomdofCoo,miaaionero Yua0NoEt< A budget amendment is necessary <br /> before approval YesEl NoM. If budget umcodmcntianeceeeary. please attach to this form. This instrument has been pre-audited in the <br /> manner required by the Local Government Budget and Fiscal Con Act: <br /> / <br /> F�xuncimlServices 0^kmoomwr`mSignature: 14"4".44/ Date:D �� ^it��/ i2- <br /> County Attorney <br /> Approval by Board Ej (Contracts $90,800.00 or more for goods or services, $250,000.00 or more for construc\\on, or any BOCC <br /> consultant contract). Approval by Manager (Most other contracts$1,000 and above). Department Director approval only El (Under <br /> $1.000). This contract has b reviewed and approved by the Attorney as to legal form and sufficiency: <br /> J <br /> Attorney's Signature <br /> Date: 7/2 7�r2 <br /> County Manager <br /> This contract has been reviewed and is approved by the County M NoEj. <br /> This contract has been reviewed and is for s - . esLJNoa. <br /> 0 I r�� I <br /> • 7/Z Z 7,/ <br /> Manager's Signature: Date: <br /> Clerk to the Board <br /> Approved by BOCC on the day of ,20 . 8"bmiocdto,Cbuirsigomu,coutbcduyn{ .20 <br /> Clerk's � <br /> 0i�mmtomu� Date: <br /> Revised March 2012 <br />