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I=Z�13- <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: KidSCope Party/Vendor Contact Person: A.M. Mathers Contact Phone: Party/Ven r Ad ess: 500 N. <br /> Nash St. City Hillsborough State:NC Zip: 27278 Department: Finance and Administrative Services Amount- 75 0 Purpose: <br /> Outside Agency Budget Code(s): 10495050-710015 Vendor# 800060 (N/A if new vendor) Vendor is a B o ultant? Yes ❑ <br /> No® Contract Type: (Check one)New ❑ Renewal ® Amendment E] Effective Date July 1,2013 Approved y Board Yes®No <br /> ❑ 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: l (� /I <br /> Department Director's Signature: t�1 t � ,� Date: ° I`1 (-� <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 ement <br /> Include the following coverages: & GL; Auto; [i' WC; Er Professional; ❑ Property; OR No Insurance Required E]. 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: A A --l4,v-- Date: hVi }� <br /> Financial Services <br /> This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No[9/ A budget amendment is necessary <br /> before approval Yes❑ No[Z.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:g 'tiG.w A. Date: gllq/lj <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 been iewe nd approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: !1 <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 it Yes❑Nc <br /> Manager's Signature: Date: <br /> l <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 />