Orange County NC Website
o:�ol�s-- I*" n <br /> 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: Senior Care of Orange County Party/Vendor Contact Person: Alvonia Baldwin Contact Phone: <br /> Party/Vendor Address: 105 Meadowlands Dr. City Hillsborough State:NC Zip:27278 Department: Aging Amount: $10,000 Purpose: <br /> Caregiver Respite Budget Code(s): 10432020-630105 Vendor#52717 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑ <br /> No® Contract Type: (Check one)New❑ Renewal® Amendment ❑ Effective Date 07/01/2013 Approved by Board Yes❑No <br /> ❑ Agenda Date: Title of Contract: Respite Care Provider <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: anuGG Date: /3 <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 19/Hold <br /> Contract pending receipt of Certificate of Insurance E]. With incorporation of Insurance provisions as shown,this contract is approved <br /> by the Risk Manager: n <br /> Risk Manager's Signature: "l �' 't`' ✓� Date: S 13 <br /> `NQ . to 1 14113 <br /> Financial Services <br /> This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No[ A budget amendment is necessary <br /> before approval Yes❑No[1�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: cis /J• / , Date: <br /> County Attorney <br /> Approval by Board ❑ (Contracts $90,OOQ.09 or more for goods or services, $250,000.00 or more for construction, or any BOCC <br /> consultant contract). Approval ana er Yom,((Most other contracts$1,000 and above). Department Director approval only❑(Under <br /> $1,000). This contract has bee ev w d approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Ye��N ❑. <br /> This contract has been reviewed and is for signs a by the C Yes❑N;� <br /> Manager's Signature: Date: <br /> lerk 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 />