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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: Habitat for Humanity Party/Vendor Contact Person: Susan Lew Contact Phone: Party/Vendor Address: 88 <br /> Vilcom Center Dr., L110 City Chapel Hill State: NC Zip: 27514 Department: Finance&Administrative Services Amount: $20,000 <br /> Purpose: Outside Agency Budget Code(s): 10495050-710023 Vendor#800020 (N/A if new vendor) Vendor is a BOCC consultant? <br /> Yes ❑No® Contract Type: (Check one)New ❑ Renewal ® Amendment ❑ Effective Date July 1,2013 Approved by Board <br /> Yes®No❑ Agenda Date: June 18,2013 Title of Contract: Outside Agency Performance Agreement <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: C <br /> Department Director's Signature: �'�'v`'� '�' 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 Ma a ement <br /> Include the following coverages: YCGL; [Auto; E►J 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: Date: <br /> Financial Services <br /> This Contract is conditioned on appropriation by the Board of Commissioners Yes❑Nol!?/ A budget amendment is necessary <br /> before approval Yes❑ NoEV. 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: A .2�v_ 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 LA(Most other contracts$1,000 and above). Department Director approval only ❑ (Under <br /> $1,000). This contract has been r i wed proved by the Attorney as to legal form and suffic'ency: <br /> Attorney's Signature Date: <br /> County Manaser <br /> This contract has been reviewed and is approved by the County Manager YesE]No❑. <br /> This contract has been reviewed and is for signature by the Chair �es❑No . <br /> Manager's Signature: Dafp.-- <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 />