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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 /> -T"ClY1.l-r—C Boss� Department <br /> Party/Vendor Name: 1 Party/Vendor Contact Person: Daniel Bossut Contact Phone: <br /> Party/Vendor Address:2114 Irvin Circle. City Chapel Hill State:NC Zip:27514 Department:Aging Amount: $999.00 Purpose: <br /> Instructor Budget Code(s): 10430120-629000 Vendor#NA (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® <br /> Contract Type:(Check one)New® Renewal ❑ Amendment ❑ Effective Date August 78,2013 Approved by Board Yes❑No❑ <br /> Agenda Date: Title of Contract: Senior Center Instructor <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: <br /> 61 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: El CGL; F1 Auto; F1 WC; El Professional; F1 Property; OR No Insurance Required 2 Hold <br /> Contract pending receipt of Certificate of Insurance E]. With incorporation of Insurance provisions as shown,this contract is approved <br /> by the Risk Manager: �D r <br /> Risk Manager's Signature: Date: <br /> Financial Services <br /> This Contract is conditioned 4pon appropriation by the Board of Commissioners Yes❑NoE9/ A budget amendment is necessary <br /> before approval Yes❑NoIf 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: p <br /> Financial Services Director's Signature: cht-, A Date: O ~S—�•j <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 be evie ed and approved by the Attorney as to legal form and sufficiency <br /> Attorney's Signature Date: <br /> VV <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: <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 />