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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: Interfaith Council for Social Service Party/Vendor Contact Person: John Dorward Contact Phone: <br /> Party/Vendor Address: 110 W. Main St. City Carrboro State:NC Zip: 27510 Department: Finance&Administrative Services Amount: <br /> $41,000 Purpose: Outside Agency Budget Code(s): 10495050-710022 Vendor# 800007 (N/A if new vendor) Vendor is a BOCC <br /> consultant? Yes❑No® Contract Type: (Check one)New ❑ Renewal ® Amendment ❑ Effective Date July 1,2013 Approved <br /> by Board Yes®No❑ Agenda Date: June 18,2013 Title of Contract: 2013-14 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: � <br /> Department Director's Signature: Wff4-a. f / Date: v�61I5 <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 z ement <br /> Include the following coverages: VCGL; [Auto; E5 WC; Y Professional; ❑ Property; OR No Insurance Required El. 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: �v <br /> Risk Manager's Signature: l�G � sL" Date: ilk <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 BudV164,nd Fiscal Control A t: <br /> Financial Services Director's Signature: � r 41_� Date: k16('3 <br /> '-3 <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). Approv by Manager[V(Most other contracts$1,000 and above). Department Director approval only ❑ (Under <br /> $1,000). This contract has b en revie nd approved by the Attorney as to legal form and sufficie cy: <br /> Attorney's Signature Date: ►`� <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 b the ha f' ;es❑NoEl <br /> Manager's Signature: G 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 />