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_)h --- St, 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 /> Party/Vendor Name: Andrew Wagoner Party/Vendor Contact Person: Andrew Wagoner Contact Phone:336-562-8007 Party/Vendor <br /> Address:308 Dave Smith Road City Prospect Hill State:NC Zip:27314 Department:DEAPR Amount:$4968.00 Purpose:Tae- <br /> Kwon-Do Instruction Budget Code(s):630000 Vendor if 56749 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No <br /> Contract Type:(Check one)New® Renewal❑ Amendment ❑ Effective Date July 6,2012 Approved by Board Yes❑No <br /> 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❑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: IV Date: 7 1 13/12. <br /> IT Director <br /> (App able illy to hardivare/software purchases or related services)This contract has been reviewed and approved by the Information <br /> Tecimo 'Director as to technical content and information technology specifications: <br /> IT Dir ctor Signature: Date: <br /> Risk Management <br /> Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; 0 Professional; ❑ Property; ❑ OR No Insurance Required ri. Hold <br /> Contract pending receipt of Certificate of Insurance O. With incorporation of Insurance provisions as shown,this contract is approved <br /> by the Risk Manager: y /� <br /> Risk Manager's Signature: 0�� -'tN +V i ,/4- Date: VUtt Z <br /> . 11 t`)I L <br /> • Financial Services <br /> This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No[ A budget amendment is necessary <br /> before approval Yes❑NoIlf 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 /> et <br /> Financial Services Director's Signature: "�a",.`....., A Date: 7f 24/1( Z <br /> County Attorney (( <br /> Approval by Board ❑ (Contracts over $90,000.00 for goods or services, $250,000.00 for construction, or any BOCC consultant <br /> contract). Approval by Manager 4 (All other contracts). This contract has been reviewed and approved by the Attorney as to legal <br /> form and sufficiency: <br /> Attorney's Signature Date: 7 T <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Ye No❑. <br /> This contract has been reviewed and is to be submitted or B•ACC consideration Yes❑No <br /> Manager's Signature: i' ' Date ' ' 1 <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 April 2010 <br />