Orange County NC Website
VA <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 icole Kushner, DVM Zes ). Party/Vendor Contact Person: Nicole Kushner. Contact Phone: 919- <br /> 5938428. P Address: 120 Sierra Drpel Hill. State:NC Zip: 27514 Department: Animal Services Amount:not <br /> to exceed $ and up to $800 forpose: Perform in house spay/neuter surgeries and veterinarian consulting <br /> services B 10215020 629010 8 (NIA if new vendor) Vendor is a BOC C consultant? Yes ❑ No® <br /> Contract Type: heck one)New❑ Renewal nt ❑ Effective Date 711/2013. <br /> If this is a Grant Agreement,pre-application has been approved by the Board of Commissioners Yes No If submitted for bid <br /> were bids/RFPs received Yes❑ No®. BidIRF'P number This contract has been reviewed and approved by the Department <br /> Director as to technical content: <br /> Department Director's Signature:i?A Date: b I <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 M a ement <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: <br /> Financial Services <br /> This Contract is conditioned upon appropriation by the Board of Commissioners Yes❑Noe A budget amendment is necessary <br /> before approval Yes❑No[ 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 BAl&-l-I udet and Fiscal Control Act: <br /> Financial Services Director's Signature: Date: <br /> County Attorney <br /> Approval by Board ❑ (Contracts over $25,000.00 or any BOCC consultant contract). Approval by Manager (All contracts <br /> $25,000.00 or less with the exception of BOCC consultants). This contract has been reviewed and approved by the Attorney as to legal <br /> form and sufficiency: t <br /> Attorney's Signature Date: I �3 <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Y <br /> This contract has been reviewed and is to be submitted for BOC nsiderat on s❑No <br /> Manager's Signature: Date: <br /> ilerk to the Board <br /> Approved by Board Yes❑No❑ Agenda Date: <br /> Clerk's Signature: Date: <br />