R 2013-292 Aging - Town of Chapel Hill Senior Services $50,000

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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: Town of Chapel Hill Party/Vendor Contact Person: William Webster Contact Phone: Party/Vendor Address: 405 MLK Jr. Blvd City Chapel Hill State:NC Zip:27514 Department: Aging Amount: $50,000 Purpose' Senior Services Budget Code(s): 10430105-444002 Vendor#64 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑Noo Contract Type: (Check one)New❑ Renewal® Amendment ❑ Effective Date July 1,2013 Approved by Board Yes[]No[] Agenda Date: Title of Contract:Provision of Senior Services 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 Management Include the following coverages: ❑ CGL; ❑ 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: C� Date: Z�rtp mbx . –tIZCo Financial Services This Contract is conditioned a on appropriation by the Board of Commissioners Yes❑No[Rll� A budget amendment is necessary before approval Yes❑No . 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 nd Fiscal Contro1C�ct: Financial Services Director's Signature: CG , Date: /4//� County Attorney Approval by Board ❑ (Contracts $90,000 0 or more for goods or services, $250,000.00 or more for construction, or any BOCC consultant contract). Approval by Manager Z(Most other contracts$1,000 and above). Department Director approval only❑ (Under $1,000). This contract has been re e d iroved by the Attorney as to legal form and sufficie cy: Attorney's Signature Date. �3 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 air Yes❑N 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