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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: US TaeKwon Do Center Party/Vendor Contact Person: Steve Kim Contact Phone: 919-730-3697 Party/Vendor <br /> Address: 15201 Rose Garden Lane City Durham State:NC Zip:27707 Department: DEAPR Amount: $3675 Purpose: Tae Kwon Do <br /> Instruction Budget Code(s): 630000 Vendor#61681 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract <br /> Type: (Check one)New® Renewal ❑ Amendment ❑ Effective Date July 1,2013 Approved by Board Yes❑No® Agenda <br /> Date: Title of Contract: Tae Kwon Do Instruction <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: r�,UC u T Date: lboll-1 <br /> IT Director <br /> (Applicab on to hardware/software purchases or related services)This contract has been reviewed and approved by the Information <br /> Technology ector as to technical content and information technology specifications: <br /> IT Director's ignature: Date: <br /> Risk Management <br /> Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required 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: JJ, Date: <br /> Financial Services <br /> This Contract is conditioned pon appropriation by the Board of Commissioners Yes❑Nov A budget amendment is necessary <br /> before approval Yes[]N 0 . 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 Bud et and Fiscal Cont r 1 Act: <br /> Financial Services Director's Signature: N�1(i��✓ ��'✓ Date: <br /> County Attorney <br /> Approval by Board ❑ (Contracts $90,000.00 more for goods or services, $250,000.00 or more for construction, or any BOCC <br /> consultant contract). Approval by Managerell other contracts). This contract has been reviewed and approved by the Attorney as <br /> to legal form and sufficiency: <br /> Attorney's Signature Date: <br /> County Manager <br /> This contract has been reviewed and is approved by th unty Manager Y No❑. <br /> This contract has been reviewed and is for sItr F�air Yes No <br /> g g Mana er s Si nature: Date: <br /> Clerk to the Board <br /> Approved by O C on the_day of ,20 . Submitted for Chair signature on the day of 20 <br /> Clerk's Signatur . Date: <br /> Revised November 2011 <br />