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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: Nina Maier Party/Vendor Contact Person:,,ff9--Z-)Contact Phone: Party/Vendor Address: 3302 Pearson <br /> Road City Hurdle Mills State:NC Zip: 27541 urp <br /> a Department, TuW. <br /> o $ 400. ose: Instructor Budget Code(s): 29430320- <br /> . Q_IT-f r <br /> 630000 Vendor#51178 (N/A if new vendor) Vendor is�A*t0nsuAant?_-Ttsr[_3 NoE Contract Type:(Check one)New❑ <br /> RenewalZ Amendment ❑ Effective Date July 1,2013 Approved by Board YesEJNoF_1 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: a-,77-13 <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; F-1 Property; OR No Insurance Require 2'." 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: d A !� Date: '71,11 <br /> Financial Services <br /> This Contract is conditioned)4pon appropriation by the Board of Commissioners YesF-lNoER/ A budget amendment is necessary <br /> before approval YesF_1 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: Date: <br /> County Attorney <br /> Approval by Board r_1 (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 N(Most other contracts$1,000 and above). Department Director approval only❑ (Under <br /> $1,000). This contract has bee eviewe nd approved by the Attorney as to legal form and sufficimc <br /> Attorney's Signature <br /> County Manager <br /> This contract has been reviewed and is approved by the County M pager Yesn NoM. <br /> This contract has been reviewed and is for signature b the Chaj es❑Nog-- <br /> Manager's Signature: Date: <br /> Jerk 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 />