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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: Senior Care of Orange County Party/Vendor Contact Person: Alvonia Baldwin Contac one: 19-245-2017 <br /> Party/Vendor Address:PO Box 8181 City Hillsborough State:NC Zip: 27278 Department:DSS Amou : $20,000 urpose: Adult <br /> Day Health Services Budget Code(s): 10405020-764100 Vendor#52717 (N/A if new vendor) Vend is a eC'�onsultant? Yes <br /> ❑No❑ Contract Type: (Check one)New❑ Renewal® Amendment ❑ Effective Date Approved by Board Yes®No❑ <br /> Agenda Date: 05/07/13 Title of Contract: Senior Care of Orange County <br /> If this is a Grant Agreement, pre-application has been approved by the Board of Commissioners Yes❑Nor]. 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: <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 Manguement <br /> Include the following coverages: D?111C'GL; VAuto; V 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: r <br /> Risk Manager's Signature: I�� Date: t j I <br /> Financial Services <br /> This Contract is conditioned u appropriation by the Board of Commissioners Yes❑No 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 /> aFinancial Services Director's Signature: P� Date: <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 revi d nd approved by the Attorney as to legal form and suffici ncy: �p <br /> Attorney's Signature Date: p <br /> County Manner <br /> This contract has been reviewed and is approved by the County Manager Yes <br /> This contract has been reviewed and is for signature by the Crto No <br /> Manager's Signature: Date: ! <br /> C Board <br /> Appr oved 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 />