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ORANGE COUNTY—CONTRACT CONTROL SHEET <br /> Routing Order: (l)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 ie not appropriate for Manager approval the Manager shall submit the contract for B{)CCapproval. Contracts for <br /> B0CC approval must be submitted throuah, and complete,the routing process prior to agenda review. Contracts for legal review nbuold <br /> be completed through the legal review process prior to being routed for signature. <br /> Department <br /> Party/VeodwrY4ume: Iildalextorjs Party/Vendor Contact Person: same Contact Phone:_____ 9az�/Veudu/Add�oo:Z5}Weaver <br /> Dairy Road, #204 City Ch��J�8S NC Zip:27514 Department:Aging $�K��U Purpose:Fit Feet Nurse Budget <br /> Cocle(s): 29430320-622000 Vendor#58380 (N/A if new vendor) Vendor is a BOCC consultant? Yes r_1 NoE Contract Type: <br /> (Check one)New R Renewal Z Amendment F� Effective Date July 1,2013 Approved by Board YesFj NoEl Agenda Date: <br /> Title of Contract: Wellness Instructor <br /> I f'///» /` u Grant Agreement, pre-application has been approved oy the Board o/ Commissioners xeuLJmoLJ. u submitted for bid were <br /> hido'K|'Ps received YemF_1NoM 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: <br /> IT Director <br /> (Applicable only uohurdwmzvsoftvoru purchases or related services)This contract has been reviewed and approved hy the Information <br /> Technology Director as to technical content and information technology specifications: <br /> IT Director's Signature: Date: <br /> Risk Manaaemen <br /> Include the following coverages: R CGL; F� Auto; Fl WC; [_l PooO:omkn/ul; M Property; OR No Insurance Required FE^ Hold <br /> Contract pending receipt ofCcrtifioatenfInsurance F]. With incorporation of Insurance provisions oy shown,this contract imapproved <br /> 6y the Risk Manager: <br /> Risk Manager's Signature: Dute: / <br /> � — - -- � <br /> Financial Services <br /> ]'his Contract isconditioned Won appropriation hy the Board of Commissioners YeunNuEO & budget amendment iunecessary <br /> hc|orc approval Y*xF� No[g. |y budget amendment is necessary, p|muoo attach to this 0nnu. This instrument has been pre-audited in the <br /> nnaonerpcquiod by the Local Government Budget and Fiscal Control : <br /> Piuuwxiul Services Director's Signature: J) A-- Date: IN13 <br /> County Attorney <br /> Approval by Board El (Contracts $9008 or more for goods or services, $250,000.00 or more for construction, or any 8OCC <br /> consultant contract). Approval by @8uougc,W (Most other contracts$1`000 and above). Department Director approval only Fl(Jodor <br /> S|.00O). This contract has be revie and approved by the Attorney as to legal form and suffici <br /> Attorney's Signature Date: <br /> County Manage <br /> 'This contract has been reviewed and is approved by the County Manager YesFrNoD. <br /> This contract has been reviewed undi for signature by the Chair YesMNoff7_ <br /> 5 � �� <br /> Manager's Signature: Dme: <br /> Clerk to the Board <br /> Approved by B0CC on the___day of 20 . Submitted for Chair signature oo the___day of 20____ <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />