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coq <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 Name: Gggy Neja Party/Vendor Contact Person: same ontact P n Party/Vendor Address: 310 Sylvan WUd <br /> City Chapel Hill State:NC Zip:27516 Department: Aging Arno . 875. rpose: Instructor Budget Code(s): 29430320-630000 <br /> NoE Contract Type:(Check one)New E] Renewal <br /> Vendor#61493 (N/A if new vendor) Vendor is a BOCC consul M. i <br /> EJ Amendment ❑ Effective Date July 1,2013 Approved by Board Yes❑No❑ Agenda Date: Title of Contract: <br /> 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: 4-,27-,13 <br /> 0 <br /> IT Director <br /> (Applicable only to hardwarelsoftware 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; r_1 WC; ❑ Professional; ❑ Property; OR No Insurance Require [9'."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: 0"t, Date: -71, <br /> Financial Services <br /> This Contract is conditioned tWon appropriation by the Board of Commissioners YesONog A budget amendment is necessary <br /> before approval Yes❑ No[7. 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: 07 I'[15 <br /> _ <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 b eview d and approved by the Attorney as to legal form and suffic* nc <br /> Attorney's Signature Date: <br /> County Manager A."ev- 12a4""d <br /> This contract has been reviewed and is approved by the County Manager YeSO�on- 'rx'02-rw <br /> This contract has been reviewed and is for signature by ke Chair Yes❑NoK?--- <br /> Manager's Signature: A14 A'M Date: <br /> .ell V <br /> Clerk to the Board <br /> Approved by BOCC on the day of 20 Submitted for Chair signature on the day of 120 <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />