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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: Lara Balian Party/Vendor Contact Person: same Contact Phone: Party/Vendor Address: 101 Highway 54, <br /> Apt B7 City Carrboro State:NC Zip:27510 Department:Aging Amount: $2,000 Purpose:MAP Budget Code(s): 10432020-620000 <br /> Vendor#61905 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No❑ Contract Type:(Check one)New® Renewal <br /> ❑ Amendment ❑ Effective Date May 20,2013 Approved by Board Yes❑No❑ Agenda Date: Title of Contract:Master <br /> Aging Plan Intern <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: <br /> IT Director <br /> (Applicable only to hardwarelsoftware 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 ❑. With incorporation of Insurance provisions as shown,this contract is approved <br /> by the Risk Manager: <br /> Risk Manager's Signature: + / Date: t 3 <br /> . ��') <br /> Financial Services <br /> This Contract is conditioned qpon appropriation by the Board of Commissioners Yes❑No[q./ A budget amendment is necessary <br /> before approval Yes❑NoIf budget amendment is necessary,please attach to this form. This instrument has been pre-audited in the <br /> manner required by the Local Government Budgq and Fiscal Control t: <br /> Financial Services Director's Signature: �""f� l3�''-G"-' ° /)4.,- Date: 5 <br /> County Attorney <br /> Approval by Board ❑ (Contracts $90,00 . 0 or more for goods or services, $250,000.00 or more for construction, or any 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 bee r ie d approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: s3D �3 <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Yw NoQ. <br /> This contract has been reviewed and is for signature by the it Yes❑Noe-, <br /> Manager's Signature: Date: <br /> Clerk to the Board <br /> Approved by BOCC on the J day of ,20 . Submitted for Chair signature on the day of ,20 <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />