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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: Lisa Duff Party/Vendor Contact Person: Lisa Duff Contact Phone: 919-369-4890 Party/Vendor Address:2393 <br /> Moncure Pittsboro Rd City Pittsboro State:NC Zip:27559 Department:ANIMAL SERVICES Amount:not to exceed$126.00 <br /> Purpose:Provide Microchipping Services for clinic Budget Code(s): 10215020 629003 Vendor#62008 (N/A if new vendor) Vendor <br /> is a BOCC consultant? Yes❑No® Contract Type:(Check one)New® Renewal❑ Amendment ❑ Effective Date 7/18/2013 <br /> Approved by Board Yes❑No® Agenda Date:NA Title of Contract: Contract Under$1,000 Lisa Duff-Microchipping Services for <br /> Clinic <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: +q <br /> Department Director's Signatu Date?2•1 a <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 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: /y i <br /> Risk Manager's Signature: �w��' �' Date: <br /> Financial Services <br /> This Contract is conditioned on 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 Budge.tand Fiscal Control A p 2 <br /> Financial Services Director's Signature: �-t-/ Date: t1 2' t J <br /> County Attorney <br /> Approval by Board ❑ (Contracts over $90,000.00 for goods or services, $250,000.00 for construction, or any BOCC consultant <br /> contract). Approval by Manager ❑ (All other contracts). This contract ha�n reviewed and approved by the Attorney as to legal <br /> form and sufficiency: AA �,frvtpl,f �1 <br /> Attorney's Signature Date: Z <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Yes[]Nor-1. <br /> This contract has been reviewed and is to be submitted for BOCC consideration Yes❑No❑. <br /> Manager's Signature: Date: <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 April 2010 <br />