Orange County NC Website
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: Sarah Benedict Party/Vendor Contact Person: same Contact Phone:_ Party/Vendor Address: 302 Waterside Drive <br /> City Carrboro State:NC Zip:27510 Department:Aging Amount: $500.00 Purpose: Wellness Class Instructor Budget Code(s): <br /> 29430320-630000 Vendor#38196 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type: (Check one) <br /> New® Renewal❑ Amendment ❑ Effective Date 03/25/2013 Approved by Board Yes®No® Agenda Date: Title of <br /> Contract: Wellness-Benedict <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: 3 a 13 <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; ❑• Professional; ❑ Property; OR No Insurance Required Hold <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 /> Financial Services <br /> This Contract is conditioned/Pon appropriation by the Board of Commissioners Yes❑NoE!r A budget amendment is necessary <br /> before approval Yes❑NoM. 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: Y04 ' /V A— Date: <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 BOCC <br /> consultant contract). Approval b Manager❑ (Most other contracts$1,000 and above). Department Director approval only (Under <br /> $1,000). This contract has been a 'ewe proved by the Attorney as to legal form and sufficiency: /T <br /> r <br /> Attorney's Signature Date: <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager cT <br /> This contract has been reviewed and is for signature by Chair Yes❑No <br /> Manager's Signature: -19 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 />