R 2013-016 Housing - NC Department of Health and Human Services $121,000

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ORANGE COUNTY — CONTRACT CONTROL SHEET Routing Order: (1) Department, (2) IT, (3) Risk Management, (4) Financial Services, (5) Attorney, (6) Manager, (7) Clerk This Document shall accompany all contracts and shall be submitted for signature in the Routing Order specified above. If the Manager determines the contract is not appropriate for Manager approval the Manager shall submit the contract for BOCC approval. Contracts for BOCC approval must be submitted through, and complete, the routing process prior to agenda review. Contracts for legal review should be completed through the legal review process prior to being routed for signature. Department Party/Vendor Name: NC Department of Health and Human Services. Party/Vendor Contact Person: Michael Leach. Contact Phone: 919- 8554991. Party/Vendor Address: 2001 Mail Service Center. City Raleigh. State: NC Zip: 27699 Department: Housing/Human Rights and Community Development Amount: $121,000 Purpose: Emergency Shelter Solutions Grant Budget Code(s): To be determined Vendor # (N /A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New Renewal ❑ Amendment ❑ Effective Date 12/13/12. If this is a Grant Agreement, pre - application has been approved by the Board of Commissioners YeSA No If submitted forbid were bids /RFPs received Yes[] Non. Bid/RFP number This contract has been reviewed and approved by the Department Director as to technical content: Department Director's Signature: Date: IT a or (Applicable only to hardware/software purchases or related services is contract has been reviewed and approved by the Information Technology Director as to technical content and information techn ogy ecifications: IT Director's Signature: Date: Risk a ent Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ PX ssional; ❑ Property; ❑ OR No Insurance Required ❑. Hold Contract pending receipt of Certificate of Insurance ❑. With inc or 'on of Insurance provisions as shown, this contract is approved by the Risk Manager: Risk Manager's Signature: Date: Financial Services This Contract is conditioned pon appropriation by the Board of Commissioners Yes❑No[v]� A budget amendment is necessary before approval Yes❑ NoM. If budget amendment is necessary, please attach to this form. This instrument has been pre- audited in the manner required by the Local Government Budget and Fiscal Control Act: Financial Services Director's Signature: da IA' � 4u" Date: 3 13 County Attorney Approval by Board ❑ (Contracts over $25,000.00 or any BOCC consultant contract). Approval by Manager ❑ (All contracts $25,000.00 or less with the exception of BOCC consultants). This contract hap been reviewed and approved by the Attorney as to legal form and sufficiency: 1/24 Attorney's Signature Date: I 3 2b) County Manager This contract has been reviewed and is approved by the County Manager Yes o❑ This contract has been reviewed and is to be submitted for BOC nsi tion Yes❑NoEr � Manager's Signature: Date: v r Clem to the Board Approved by Board Yes❑ No❑ Agenda Date: Clerk's Signature: Date: