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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: CHAKA Party/Vendor Contact Person: Marvin Axelrod Contact Phone: Party/Vendor Address: 116 Brook <br /> Lane City Durham State:NC Zip:27712 Department:Library Amount; 75 Purpose:Programming Budget Code(s): 10500020 <br /> 630000 Vendor#38440 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type:(Check one)New <br /> Renewal❑ Amendment ❑ Effective Date Approved by Board Yes❑No® Agenda Date: Title of Contract: <br /> If this is a Grant Agreement,pre-application has en approved by the Board of Commissioners Yes❑No®. If submitted for bid were <br /> bids/RFPs received Yes❑No® Bid/RFP er This contract has been reviewed and approved by the Department Director as to <br /> technical content: <br /> Department Director's Sig re: Date: <br /> irector <br /> (Applicable only to hardware/so lare r chases 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 Manaaement <br /> Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required ®. 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: Y j <br /> Financial Services <br /> This Contract is conditioned upon 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 a and Fiscal <br /> ' C7f Act: <br /> ure: <br /> Date:Financial Services Director's Si gnat <br /> l L <br /> _ — <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 eviewed and approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: <br /> County Manaaer <br /> This contract has been reviewed and is approved by the County Manager Yesallo®. <br /> This contract has been reviewed and is for signat bly the Chair Yes❑No®. <br /> Manager's Signature: +J ' ' Date. <br /> 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 March 2012 <br />