Orange County NC Website
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: Barbara Lang Party/Vendor Contact PSC same Con hon� Party[Vendor Address: 905 Cedar Fork <br /> Trail City Chapel Hill State:NC Zip: 27514 Department: mount:Mr400. Purpose: Instructor Budget Code(s): 29430320- <br /> 630000 Vendor#44068 (N/A if new vendor) Vendor is consul ❑No® Contract Type: (Check one)New❑ <br /> Renewal® Amendment ❑ Effective Date July 1,2013 Approved by Board Yes❑No❑ 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 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: 6-.27-13 <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 Q' 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: �> l f J,�✓ <br /> Risk Manager's Signature: Vl ✓A J` Date: /h2 <br /> Financial Services <br /> This Contract is conditioned 0on appropriation by the Board of Commissioners Yes❑NoEZ 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 Budget and Fiscal Control Act: <br /> ' Signature: A-8 e-_".1 A N�`'`�- Date: '7 <br /> Financial Services Director's S�gnat <br /> County Attorney <br /> Approval by Board ❑ (Contracts $90,000.00 or more for goods or services, $250,000.00 or 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 beop revi ed and 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 YesE2-<o❑. <br /> This contract has been reviewed and is for sig ure b th hair Yes❑NoEr_ '�f x <br /> Manager's Signature: Date: ` 3 r ✓ <br /> I <br /> Clerk 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 />