Orange County NC Website
Browse       Search
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 /> Partv'Vendor Name: Martha Broda Party/Vendor Contact Person: _' - Contact ho Party[Vendor Address: 1388 Mantis <br /> _s <br /> Chapel Road City Pittsboro State:NC Zip:27312 Departmen `Ain mount:t J=00(P0).0.V urpose: Instructor Budget Code(s): <br /> ❑NoZ Contract Type:(Check one) <br /> 29430320-630000 Vendor#58627 (N/A if new vendor) Ve=ia�OCC q <br /> ,6as�t? Yes r <br /> New❑ Renewal 0 Amendment ❑ Effective Date July 1,2013 Approved by Board Yes❑Non Agenda Date: Title of <br /> Contract: Wellness Instructor <br /> If this is a Grant Agreement, pre-application has been approved by the Board of Commissioners Y esn No❑ If submitted for bid were <br /> bids/RFPs received Yes❑Non Bid/RFP number This contract has been reviewed and approved by the Department Director as to <br /> technical content: <br /> Department Director's Signature: QA.4�4 Date: <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 12/• Hold <br /> Contract pending receipt of Certificate of Insurance n. With incorporation of Insurance provisions as shown,this contract is approved <br /> by the Risk Manager: <br /> Risk Manager's Signature: aa�, 4t AA/" Date: <br /> LP 1 zz <br /> Financial Services <br /> This Contract is conditioned 4pon appropriation by the Board of Commissioners YesFINo[E. A budget amendment is necessary <br /> before approval Yesn Nog. 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:A�414,4,_- A A., Date: ',I/, <br /> County Attorney <br /> Approval by Board ❑ (Contracts $90,000.00 or more for goods or services, $250,000.00 o- more for construction, or any BOCC <br /> consultant contract). Approval by Manager` (Most other contracts$1,000 and above). Department Director approval only❑(Under <br /> $1,000). This contract has roved by the Attorney as to legal form and suffic <br /> Attorney's Signature Date:—,(ency: <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager YesPi'N4o❑. <br /> I-his contract has been reviewed and is for sigriatur Yes❑NoL?. <br /> Manager's Signature: Date.i <br /> Clerk to the Board <br /> Approved by BOCC on the day of Submitted for Chair signature on the day of _,20 <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />