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B 4 <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: The Women's Center DB/A/Compass Center for Women and Families formerly,Family Violence Prevention <br /> Center Party/Vendor Contact Person: Ann Gerhardt Contact Phone:919-968-4610 Party/Vendor Address:210 Henderson Street City <br /> Chapel Hill State:NC Zip:27514 Department:Outside Agency Amount:$21,500 Purpose:Outside Agency Budget Code(s): <br /> 10495050-719001 Vendor#NEW (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type:(Check one) <br /> New® Renewal❑ Amendment ❑ Effective Date 07/01/2012 Approved by Board Yes®Non Agenda Date:06/19/2012 <br /> Title of Contract:2012-13 Outside Agency Performance A Bement <br /> If this is a Grant Agreement,pre-application has bee ppr by the Board of Commissioners Yes❑Non. If submitted for bid were <br /> bids/RFPs received Yes❑No❑ Bid/RFP numbe s contract has been reviewed and approved by the Department Director as to <br /> technical content: j <br /> Department Director's Signature: Date: r r " <br /> T Director <br /> (Applicable only to hardware/software purchases or re is ntra has been reviewed and approved by the Information <br /> Technology Director as to technical content and information technology spe ions: <br /> IT Director's Signature: Date: <br /> Risk Manaaemen.t <br /> Include the following coverages: 9CGL; [A Auto; WC; - Professional; ❑ Property; ❑ OR No Insurance Required ❑. Hold <br /> Contract pending receipt of Certificate of Insurance 9. With incorporation of Insurance provisions as shown,this contract is approved <br /> by the Risk Manager: <br /> Risk Manager's Signature: ✓/. ���'�"' Dater�z <br /> Financial Services <br /> This Contract is conditioned jjpon appropriation by the Board of Commissioners Yes❑No5( A budget amendment is necessary <br /> before approval Yes❑NoNj. 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 Contr 1 Act: <br /> aa,�Financial Services Director's Signature: 111��- 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 Mana ❑ (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: <br /> County Mana er <br /> This contract has been reviewed and is approved by the County Manager Ye)nesoNoW <br /> o❑ <br /> This contract has been reviewed and is to be submitted for BOCC siderati / <br /> Manager's Signature: Date: <br /> C erk 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 />