Orange County NC Website
Browse       Search
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: Getty Nejad Party/Vendor Contact Person: same Contact Phone: Party/Vendor Address: 310 Sylvan Way <br /> City Chapel Hill State:Nc Zip:27514 Department: aging Amount: $875.00 Purpose: Wellness Instructor Budget Code(s):29430320- <br /> 630000 Vendor#61493 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type:(Check one)New <br /> Renewal❑ Amendment ❑ Effective Date 09/01812 Approved by Board Yes❑No❑ Agenda Date: Title of Contract: <br /> Wellness-Nejad <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: QA�g� Date: <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 /> Risk Management <br /> Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required 5� 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: �Risk Manager's Signature: �, Date: <br /> Financial Services <br /> This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No 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 Bud /'d Fiscal Controll ct: <br /> g <br /> Financial Services Director's Si nature: ✓" � Date: Ql G 2 <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 P (Under <br /> $1,000). This contract has been eviewed and approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Ye%�No❑. <br /> This contract has been reviewed and is for ' nature by hair Yes❑NoQ- <br /> Manager's Signature: Date: Z--/ <br /> L-- <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 /> �l <br /> Revised March 2012 <br />