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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: Ginger Mann PartyNendor Contact Person: Ginger Mann Conta 'hone: PartyNendor Address: 5437 <br /> Stewartby Drive City Raleigh State:NC Zip:27613 Department:Health Amount: 4,500 Purpose: Program Coordinator for <br /> Smart Smiles Dental Screening,Education and Referral Program for Young Children e-=': Code(s): 10410020 630000 Vendor# <br /> 43826 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No Contract Type: (Check one)New❑ Renewal <br /> Amendment El Effective Date July 1,2012 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❑Non. If submitted for bid were <br /> bids/RFPs received Yes❑Non Bid/RFP number This contract has been reviewed and approved by the Department Director as to <br /> technical content: See <br /> t. --.Director's Signature: S!w"-- 5.1c1.6,,.. Date: i iirllla <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 /> f Risk Management <br /> Include the following coverages: [VJ CGL; Id Auto; WC; El Professional; ❑ Property; ❑ OR No Insurance Required ❑. 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: r JJ// fi Risk Manager's Signature: '` , 4'4-- Date: _427 <br /> iL. i711'i11. <br /> Financial Services <br /> This Contract is conditions upon appropriation by the Board of Commissioners Yes❑No . A budget amendment is necessary <br /> before approval Yes❑ No[l]. 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 /> (q�(` , JI�J''`� if 2b Il/f- <br /> Financial Services Director's Signature: �.� Date: <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 Mai •ger 1�/ (All other contracts). This contract has been reviewed and approved by the Attorney as to legal <br /> form and sufficiency: ' / <br /> Attorney's Signature �1�__. Date:i 12- <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Yeallo❑. <br /> This contract has been reviewed and is to be ;i• i,-• f.r :,I CC consideration Yes❑NQO- <br /> / / � <br /> Manager's Signature: _ II `r�4 Date: 7- �' <br /> V. ,•�k 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 />