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a?o <br /> 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: The Arc of Orange County Party/Vendor Contact Person: Robin Baker Contact Phone: Party/Vendor <br /> Address: 208 N. Columbia St. City Chapel Hill State:NC Zip: 27514 Department:Finance&Administrative Services Amount: $4,000 <br /> Purpose: Outside Agency Budget Code(s): 10495050-719023 Vendor# 50706 (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: 2013-14 Outside Agency Performance Agreement <br /> If this is a Grant Agreement, pre-application has been approved by the Board of Commissioners Yes F]No❑. If submitted forbid 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: �(l <br /> Department Director's Signature: `�� � /� Date: u! <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: 4 CGL; [`Auto; I 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: <br /> Risk Manager's Signature: (�{,. ' Date: 3 <br /> Financial Services <br /> This Contract is conditioneAd_Xpon appropriation by the Board of Commissioners Yes❑No . A budget amendment is necessary <br /> before approval Yes❑ NoV. 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 Bud et and Fiscal Contro Date: 3 ct: <br /> W`ww ✓� �' t <br /> Financial Services Director's Signature: <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 Tr approved by the Attorney as to legal form and sufficiency: <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 by the Chair Yes❑No/�]. <br /> Manager's Signature: ',.y -K 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 />