R 2013-306 Finance - Orange County Disability Services Outside Agency $2,500

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ORANGE COUNTY-CONTRACT CONTROL SHEET Routing Order: (1)Department, (2)IT, (3)Risk Management, (4)Financial Services,(5)Attorney, (6)Manager,(7)Clerk This Document shall accompany all contracts and shall be submitted for signature in the Routing Order specified above. If the Manager determines the contract is not appropriate for Manager approval the Manager shall submit the contract for BOCC approval. Contracts for BOCC approval must be submitted through, and complete,the routing process prior to agenda review. Contracts for legal review should be completed through the legal review process prior to being routed for signature. Department Party/Vendor Name: Orange County Disability Services Party/Vendor Contact Person: Timothy Miles Contact Phone: Party/Vendor Address: 503 W. Franklin St., Rm 113 City Chapel Hill State:NC Zip: 27516 Department: Finance&Administrative Services Amount: $2,500 Purpose: Outside Agency Budget Code(s): 10495050-710032 Vendor# 800037 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one)New ❑ Renewal® Amendment ❑ Effective Date Jul 1 2013 Approved by Board Yes®No❑ Agenda Date: June 18,2013 Title of Contract: 2013-14 Outside Agency Performance Agreement If this is a Grant Agreement, pre-application has been approved by the Board of Commissioners Yes❑No❑. If submitted for bid were bids/RFPs received Yes❑No❑ Bid/RFP number This contract has been reviewed and approved by the Department Director as to technical content: ,� - Department Director's Signature: � Date: IT Director (Applicable only to hardware/software purchases or related services)This contract has been reviewed and approved by the Information Technology Director as to technical content and information technology specifications: IT Director's Signature: Date: Risk Manaaement Include the following coverages: EZ/CGL; EL(Auto; WC; Professional; ❑ Property; OR No Insurance Required ❑. Hold Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as shown, this contract is approved by the Risk Manager: Risk Manager's Signature: '�^� �� Date: J �' Financial Services This Contract is conditioned Oon appropriation by the Board of Commissioners Yes❑NoER./ A budget amendment is necessary before approval Yes[:] NoEV. If budget amendment is necessary, please attach to this form. This instrument has been pre-audited in the manner required by the Local Government Bud et and Fiscal Control�)'t: Financial Services Director's Signature: 6( ({_, Date: �/ 4/3 County Attorney Approval by Board ❑ (Contracts $90,000 00 or more for goods or services, $250,000.00 or more for construction, or any BOCC consultant contract). Approval by Manager M(Most other contracts$1,000 and above). Department Director approval only ❑ (Under $1,000). This contract has bMed by the Attorney as to legal form and sufficiency: Attorney's Signature Date: lei County Manager This contract has been reviewed and is approved by the County Manager Yes No❑. This contract has been reviewed and is for signature by the hair Yes❑No Manager's Signature: _ Date: Clerk to the Board Approved by BOCC on the day of 20 Submitted for Chair signature on the_day of 20 Clerk's Signature: Date: Revised March 2012