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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 /> Party/Vendor Name: Senior Care of Orange ty,Inc. Party/Vendor Contact Person: Alvonia Baldwin Contact Phone: 919-245- <br /> 2017 Party/Vendor Address: 105 Meadowlands Drive City Hillsborough State:NC Zip:27278 Department:Aging Amount: <br /> $4,000.00 Purpose: Community Respite Services for Aging Transitions Budget Code(s): 10432020-630105 Vendor#52717 (N/A if <br /> new vendor) Vendor is a BOCC consultant? Yes❑No❑ Contract Type:(Check one)New❑ Renewal® Amendment ❑ <br /> Effective Date 08/15/12 Approved by Board Yes❑No® Agenda Date: Title of Contract:Respite Care <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: Date: /O-/L <br /> IT Director <br /> (Applicable only to hardwarelsoftware 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; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required T/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: (j <br /> Risk Manager's Signature: C t_1 �. Date: D l2 <br /> Financial Services <br /> This Contract is conditioned pon appropriation by the Board of Commissioners Yes❑No� A budget amendment is necessary <br /> before approval Yes[:]NoF 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 Bud a and Fiscal Control Act: p� <br /> Financial Services Director's Signature: N� o Date: 12' <br /> County Attorney <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 been viewed and approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: Z- <br /> County Manager <br /> This contract has been reviewed and is approved by th County Manager Yeso No❑. <br /> This contract has been reviewed and is for sig ature e Chair Yes❑No <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 />