Orange County NC Website
Browse       Search
`'DL - <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 /> Party/Vendor Name: CNC Access, Inc Party/Vendor Contact Person: David Waskey Contact Phone: 704-405-91 5 Party/Vend. <br /> Address: 830 Tyvola Road Suite 104A City Charlotte State:NC Zip:28217 Department: DSS Amount:not . exceed$75,011 <br /> Purpose: 1n-home services Budget Code(s): 10400220-630000 Vendor# (N/A if new vendor) Ven•or i - W consultant? <br /> Yes ❑No Contract Type: (Check one)New❑ Renewal ® Amendment ❑ Effective Date 07/01/12 Appro -• by Board Yes <br /> ® <br /> No Agenda Date: 06/15/12 Title of Contract: In-Home Aide Provider Services Agreement <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:Dep <br /> artment Director's Signature: " Date: (51 -10-i)- <br /> 7-//-/Z <br /> T 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 /> 1T Director's Signature: Date: <br /> Risk Man Bement <br /> Include the following coverages: [ CGL; Auto; WC; [a Professional; ❑ Property; OR No Insurance Required E. 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: -L- <br /> Risk Manager's Signature: ,D, a ""— �j Date: r 2 `12- <br /> Financial Services <br /> This Contract is conditioned Dpon appropriation by the Board of Commissioners Yes❑No[ A budget amendment is necessary <br /> before approval YesE No[ 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 /> VI,�"� <br /> Financial Services Director's Signature: 41 L Date: 1/Z 1X <br /> County Attorney <br /> Approval by BoardX (Contracts $90,000. 0 or more for goods or services, $250,000.00 or more for construction, or any BOCC <br /> consultant contract). Approval by Manager (Most other contracts$1,000 and above). Department Director approval only ❑ (Under <br /> $1,000). This contract has be review d and pproved by the Attorney as to legal form and suffici ncy: <br /> Attorney's Signature Date: .2.1 la-, <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Yesallo❑. <br /> This contract has been reviewed and is for signature by the Chair Yes❑NoR"' <br /> Manager's Signature: ^ • �A Date: ° " ./v <br /> l - <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 />