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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: Roberto Diaz Party/Vendor Contact Person: -Rob•.:rt Diaz Contact Phon • Party/Vendor Address:2213 <br /> Stroller Avenue City D urham State:NC Zip: 27705 Depurtmc ni.: Public health Amoun . 6,000 rpose:To enforce food, lodging, <br /> and Institutional sanitation laws and rules Budget Code(s): !.04110'10- 30000 Vendor# /A (N/ new vendor) Vendor is a BOCC <br /> consultant? Yes ❑No® Contract Type: (Check one)New .ciw�,al E] Amendment Effective Date July 31,2013 Approved <br /> by Board Yes❑No❑ Agenda Date: Title of Contras : REHS Service Contract <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: K,7-15 <br /> Airector <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 Maii�ig!; went ,_,/ <br /> Include the following coverages: ❑ CGL; ❑ Auto; L_i \vv; i-1 Pwfes,ional. ❑ Property; OR No Insurance Required 2 Hold <br /> Contract pending receipt of Certificate of Insurance ❑. `'Vith ir,corpu!Aiun of Insurance provisions as shown, this contract is approved <br /> by the Risk Manager: <br /> Risk Manager's Signature: lf� `` ' A Date: <br /> 'per 9l t3 <br /> Financial Services <br /> This Contract is conditioned pon appropriation by the Board of Commissioners Yes❑Noy A budget amendment is necessary <br /> before approval Yes❑NoM. 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 Control Act: <br /> 1 r� ` <br /> Financial Services Director's Signature: l c A " A11111 3�Date: G <br /> County Attorney <br /> Approval by Board ❑ (Contracts $90,000 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 bee eview a d approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature_ Date: D <br /> t_owity Jklanly er <br /> This contract has been reviewed and is approved by the Uouuty Manat er Ye,%i' o❑. <br /> This contract has been reviewed and is for signature by the.Chair Yes❑No©-- <br /> Manager's Signature: Date:,i <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 />