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Q1 <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: Harrison Brooke Party/Vendor Contact Person: same Contact Phone: Party/Vendor Address: 5323 <br /> Oakbrook Drive City Durham State:NQ Zip:27713 Department: Aging Amount: $4,000.00 Purpose: senior center bridge class <br /> Budget Code(s): 10430120-629000 Vendor 4 58534 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑NoZ Contract <br /> Type: (Check one)New❑ Renewal Z Amendment ❑ Effective Date 09/01/2012 Approved by Board Yes❑NoZ Agenda <br /> Date: Title of Contract: Senior Center-Brooke <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: Qm" &4 al-I Date: f-g 14 <br /> 0 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 /> Risk Management <br /> Include the following coverages: ❑ CGL; ❑ Auto; F-1 WC; ❑ Professional; ❑ Property; OR No Insurance Required 1� 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: Date: <br /> al L01 I z: <br /> Financial Services <br /> This Contract is conditioned_Oon appropriation by the Board of Commissioners YesE]Nom/ A budget amendment is necessary <br /> before approval Yes❑Nol M. 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 Budge l and Fiscal Control Act: <br /> Financial Services Director's Signature: Date: <br /> County Attornev <br /> Approval by Board ❑ (Contracts $90,000.00 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 bee reviewed and approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Z*4wv� Date:pia <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Yes]2140m. <br /> This contract has been reviewed and is for sl* ture by the 9hair YesF-lNog,.- <br /> Manager's Signature: Date: <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 />