R 2013-061 Health - Orange County Schools for School Nurse $232,055

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2 -iMa-C"YI-0I , ORANGE COUNTY—CONTRACT CONTROL SHEET Routing C>rder: 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: Orange County Schools Party/Vendor Contact Person: Co ct Phone- 32-8216 Party/Vendor Address: 200 E King St City Hillsborough State:NC Zip:27278 Department: Amoun 232 05 ose: School Nurses Budget Code(s): 10495020 631100 Vendor# 178 (N/A if new vendor} Vendor is a BQC c Yes❑No Contract Type:(Check one)New❑ Renewal® Amendment ❑ Effective Date 7/1/2012-6/30/2013 Approved by Board YesjNo❑ Agenda Date: Title of Contract:Agreement for School Nursing Services between the OC and Orange County Schools 1 ` If this is a Grant Agreement,pre-application has been approved by the Board of Commissioners`i'es❑No❑. If submitted for bid were bids/RFPs received Yes❑No❑ Bid/RFP number This contract has been reviewed and approved by the Department Director as to technical content: S Department Director's Signature: Date: 013 #,3 IT Director (Applicable only to hardwarelsgftware purchases or related services)This contract has been reviewed and approved by the Information Technology Director as to technical content and information technology specifications: IT Director's Signature: Date: Risk Management Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; C Professional; ❑ Property; OR No Insurance Required 9 Hold Contract pending receipt of Certificate of Insurance El. With incorporation of Insurance provisions as shown,this contract is approved by the Risk Manager: Risk Manager's Si nature: Date: Financial Services This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No[) A budget amendment is necessary before approval Yes❑ No . 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: �''` �• Date: 'Ll ' 13 County Attorney Approval by Board A(Contracts $90,000.00 or more for goods or services, $250,000.00 or more for construction, or any BOCC consultant contract). Approv 1 by Manager❑ (Most other contracts$1,000 and above). Department Director approval only❑ (Under $1,000). This contract has b rev' d approved by the Attorney as to legal form and sufficiency: Attorney's Signature Date: 1 County Manager This contract has been reviewed and is approved by the County Manage Yesvi No❑. This contract has been reviewed an is for i ature b the Chair Yes No Iff- Manager9s Signature: Date: Clerk to the Board Approved by BOCC on the_day of ,20 Submitted for Chair signature on the_day of ,20__ Clerk's Signature: Date: Revised March 2012