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aO1a- . -1 <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: Senior Care of Orange County PartyNendor Contact Person: Alvonia Baldwin Contact Phone:919-245-2017 <br /> PartyNendor Address: 105 Meadowlands Drive, Suite 500 City Hillsborough State:NC Zip:27278 Department:Outside Agency <br /> Amount:$20,000 Purpose:Outside Agency Budget Code(s): 10495050-719027 Vendor#800047 (N/A if new vendor) Vendor is a <br /> BOCC consultant? Yes El No Contract Type:(Check one)New® Renewal El Amendment El Effective Date 07/01/2012 <br /> Approved by Board Yes No❑ Agenda Date:06/19/2012 Title of Contract:2012-13 Outside Agency Performance Agreement <br /> If this is a Grant Agreement,pre-application has been a.'roved by the Board of Commissioners Yes❑No❑. If submitted for bid were <br /> bids/RFPs received Yes❑No❑ Bid/RFP mber This contract has been reviewed and approved by the Department Director as to <br /> technical content: / /' <br /> Department Director's Si. . ,ture: `VAMN,,;;,Imo Date: 7- (— <br /> a <br /> I iirector <br /> (Applicable only to hat-, ar,/software purchases or related services)This contract has been reviewed and approved by the Information <br /> Technology Director as to t- hnical content and information technology specifications: <br /> IT Director's Signature: Date: <br /> Risk M nagement <br /> Include the following coverages: [[CGL; [Auto; WC; [Professional; El Property; El OR No Insurance Required El. 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: CI aAtn,w .✓• 41..4-- Date: lb 9--( 12 <br /> Financial Services <br /> This Contract is conditioned upon appropriation by the Board of Commissioners Yes❑NoM. A budget amendment is necessary <br /> before approval Yes❑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 /> e/ w ,Z <br /> Financial Services Director's Signature: i'd Date: If/21(1' <br /> County Attorney <br /> Approval by Board X (Contracts over $90,000.00 for goods or services, $250,000.00 for construction, or any BOCC consultant <br /> contract). Approval by Man. .-r ❑ (' I other contracts). This contract has been reviewed and approved by the Attorney as to legal <br /> form and sufficiency: i ' <br /> Attorney's Signature ,�►I Date: 1 2i 12 <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Yes �o❑. <br /> This contract has been reviewed and is to be submitted for BOCC co .'deration Yes1:111430. <br /> ■I4 <br /> Manager's Signature: / /, Date: 7 ` v <br /> 4. <br /> lerk o 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 />