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DI —Brill <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: Housing for New Hope Party/Vendor Contact Person: Melissa Hartzell Contact Phone:919.489.6282 <br /> Party/Vendor Address: 18 W.Colony Place,Suite 250 City Durham State:NC Zip:27705 Department:Outside Agency Amount: <br /> $20,000 Purpose:Outside Agency Budget Code(s): 10495050-719052 Vendor#800075 (N/A if new vendor) Vendor is a BOCC <br /> consultant? Yes❑No® Contract Type:(Check one)New® Renewal❑ Amendment ❑ Effective Date 07/01/2012 Approved by <br /> Board Yes®No❑ Agenda Date:06/19/2012 Title of Contract:2012-1 Outside Agency Performance Agreement <br /> If this is a Grant Agreement,pre-application has been approved by the oar of Commissioners Yes❑No❑. If submitted for bid were <br /> bids/RFPs received Yes❑No❑ Bid/RFP number This contras has een reviewed and approved by the Department Director as to <br /> technical content: j f <br /> Department Director's Signature: ate: ! 2,,.... <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: dCGL; Auto; WC; Professional; ❑ Property; ❑ OR No Insurance Required R. 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 /> Financial Services <br /> This Contract is conditioned Ljpon appropriation by the Board of Commissioners Yes❑Nopi( A budget amendment is necessary <br /> before approval Yes❑No g.. 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 /> 6���„G,..t✓Financial Services Director's Signature: 'j. Date: I alibi i 2 <br /> County Attorney <br /> Approval by Board W (Contracts over $90,000.00 for goods or services, $250,000.00 for construction, or any BOCC consultant <br /> contract). Approval by anag (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: b <br /> County ManaEer <br /> This contract has been reviewed and is approved by the County Manager Yes Nor <br /> This contract has been reviewed and is to be submitted for B C consideration. Yes®�oLJ <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 120 <br /> Clerk's Signature: Date: <br /> Revised April 2010 <br />