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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: SECU Family House at UNC Hospitals Party/Vendor Contact Person: Kirsten Beattie Contact Phone: 919/932- <br /> 8000 Party/Vendor Address: 123 Old Mason Farm Road City Chapel Hill State:NC Zip:27517 Department:EDC-Arts Commission <br /> Amount: $1,500 Purpose:Fall 2012 Art Grant Agreement Budget Code(s):37601020-683001 Vendor#61718 (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes❑NoZ Contract Type: (Check one)New N Renewal❑ Amendment ❑ Effective Date date <br /> of last signature Approved by Board YesE No[] Agenda Date:June 19,2012(approval of FYI 3 budget) Title of Contract: <br /> Orange County Arts Commission Fall,2012 Grant Agreement <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❑NonBid/RFP number This contract has been reviewed and approved by the Department Director as to <br /> technical content: <br /> Department Director's Signature: 10-AIO 0417 Date: <br /> IT Director <br /> (Applicable only to hardwarelsoftivare 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 MHold <br /> Contract pending receipt of Certificate of Insurance El. With incorporation of Insurance provisions as shown,this contract is approved <br /> by the Risk Manager: <br /> Risk Manager's Signature: Date: <br /> Pv2L—,—. L1101Wts <br /> Financial Services <br /> This Contract is conditioned n appropriation by the Board of Commissioners YesF]NoE4./ 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 Budget and Fiscal Control Act: <br /> Financial Services Director's Signature: ► t", Date: <br /> County Attorney <br /> Approval by Board ❑ (Contracts $90,000. 0 more for goods or services, $250,000.00 or more for construction, or any BOCC <br /> 0 - 1 <br /> consultant contract). Approval by Manager 4(Most other contracts$1,000 and above). Department Director approval only❑(Under <br /> $1,000). This contract has be evie approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: b 1 <br /> L <br /> County Manner <br /> This contract has been reviewed and is approved by the Co ty Manager YeSE31qoFl. <br /> This contract has been reviewed an j* 7tnrSb hl C YesE:]NoEj- <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 /> 1 <br />