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CS '�)13 00J 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: Chapel Hill Carrboro City School Party/Vendor Contact Person: Contact Phone:919-967-8211 <br /> Party/Vendor Address:Merritt Mill Road City Chapel Hill State:NC Zip:27216 Department: Amount: $451,651 Purpose: <br /> Provide school nurses Budget Code(s): 10495020 63 1 100 Vendor#22226 (N/A if new vendor) Vendor is a BOCC consultant? Yes <br /> ❑No❑ Contract Type: (Check one)New❑ Renewal® Amendment ❑ Effective Date 7/1/2012-6/30/2013 Approved by Board <br /> Yes®No❑ Agenda Date:6/19/2012 Title of Contract:Agreement for School Nursing Services between OC and the Chapl Hill <br /> Carrboro City Schools <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: Lz <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; F1 El.Professional; Property; OR No Insurance Required . Hold <br /> Contract pending receipt of Certificate of Insurance Q�With incorporation of Insurance provisions as shown,this contract is approved <br /> by the Risk Manager: D/,j , <br /> Risk Manager's Signature: �1 V�� P, A, Date: 1117/1-3 <br /> Financial Services <br /> This Contract is conditioned won appropriation by the Board of Commissioners Yes❑NoV A budget amendment is necessary <br /> before approval Yes❑ NoRX-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: l <br /> Financial Services Director's Signature: �'�`�e.. �, "'-` Date: 7! 3 <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 b revi e aA approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: ih4 <br /> County ManageZ <br /> This contract has been reviewed and is approved by the County Manager Y . <br /> This contract has been reviewed and is for signature by the Chair Y o❑. <br /> Manager's Signature: i 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 /> E <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />