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- <br /> \ «��/� <br /> ` �^� <br /> ORANGE COUNTY—CONTRACT CONTROL SHEET <br /> Routing Order: (l)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. lf the Manager <br /> dctenoines the contract{a not appropriate for Manager approval the Manager shall submit the contract for 0OCCapproval. 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 /> Panym/ondorl«umc: Wake Radiology Diagnostic Imaging,LCC Party/Vendor Contact Person: Robert E. Schaaf Contact Phone:919- <br /> 787-8221 Pucty/Vaodo,/\ddrcme: 3949 Browning Place City Raleigh State:NC Zip:27609 Department: Public 8eddl Amount: <br /> $6,40U0 Budget Code(s): <br /> 680018 Vendor#819629 (N/A if new vendor) Vendor is a BOCC consultant? Yes M NoE Contract Type:(Check one)New <br /> Renewal Amendment M Effective Date July l, I013 Approved hyBoard `yra[]I4o[] Agenda Date: Title of <br /> Contract: Wake Radiology BCCCP <br /> If this is a Grant Agreement,pre-application has been approved by the Board of Commissioners YeuElNmEl. lf submitted for bid were <br /> bids/RFPs received ycuFlNuM 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 /> (A/),/icob/a only to hard&war s urchases or related his contract has been reviewed and approved by the lo;mouubon <br /> Technology Director as to technical conten ation technology specifications: <br /> IT Director's Signat —Date-: <br /> Risk Management <br /> Include the following coverages: E] CGL; M &mm; El WC; F1 Professional; M Property; 00 No Insurance Required [I. Bold <br /> Contract pending receipt o[CcrtifioateofInsurance []. With incorporation mf Insurance provisions uy shown,this contract iaapproved <br /> hy the Risk Manager: <br /> Risk Manager's Signature: Date: q1d13 <br /> _ —_'' .A. ^^.`' <br /> Financial Services <br /> This Contract imoouddiomd Won appropriation hy the Board ofCommissioners yeyoNom & budget amendment ianecessary <br /> before approval }'euElNoLV. If budget amendment is necessary,please attach to this form. This instrument has been pre-audited in the <br /> manner required bythe Local Government Budget and Fiscal Control Act: <br /> Financial Services Director's Signature: ,]Al,,— Date: <br /> County Attorney <br /> Approval by Board Fl ( $90000construction, or any 8OCC <br /> ooumo|tao t) | nager[Y(Most other contracts$1,000 and . Depm�mneutDimz¢ruppoomdonly[l(Under <br /> $l,0OO). 7hiacoo�auL has been wed d approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: <br /> County This contract has been,ovievvodand ia approved by the County Manugcr . <br /> This contract b 6 d FI 03^ <br /> Manager's Signature: �r <br /> Clerk to the Board <br /> Approved hyB0CCou the__.day of2O____. Submitted for Chair signature un the day of 20___ <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />