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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 /> �,(Ic. Department <br /> Party/Vendor Name: 4�°h t Ma;,,rP„a„cP ree ent Party/Vendor Contact Person: Michael Bradley Contact Phone: 919-259- <br /> 1095 Party/Vendor Address: 9961 NC Hwy 87N City Pittsboro State:NC Zip: 27312 Department: DSS Amount: $960.00 Purpose: <br /> On-site maintenance and application support for the NCDSS-DaySheet application Budget Code(s): 10400120-630000 Vendor#61342 <br /> (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No❑ Contract Type: (Check one)New® Renewal ❑ Amendment <br /> ❑ Effective Date 07/01/13 Approved by Board Yes❑No❑ Agenda Date: Title of Contract: Contract Under$10,000.00 <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: 0 )'Oct 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 (1 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: /"^'� Date: <br /> Financial Services r� <br /> This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No vLI. 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 /> Financial Services Director's Signature:��t„/ A Date: �7 <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 BOCC <br /> M <br /> consultant contract). Approv by anager❑ (Most other contracts$1,000 and above). Department Director approval only(Under <br /> $1,000). This contract has b re <br /> vi d and approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: I 2 3 <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Yes❑No[]. <br /> This contract has been reviewed and is for signature by the Chair Yes❑No❑. <br /> Manager's Signature: Date: lx <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 />