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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: Boys&Girls Club of Eastern Piedmont Party/Vendor Contact Person: Sarah Marion Contact Phone: <br /> Party/Vendor Address: P.O. Box 1788 City Pittsboro State:NC Zip: 27312 Department: Finance&Administrative Services Amount: <br /> $5,000 Purpose: Outside Agency Budget Code(s): 10495050-719055 Vendor#62140 (N/A if new vendor) Vendor is a BOCC <br /> consultant? Yes❑No® Contract Type: (Check one)New® Renewal ❑ Amendment ❑ Effective Date July 1,2013 Approved <br /> by Board 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 Yeso 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: C✓` j` Date: <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 Management <br /> Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required ❑. Hold <br /> Contract pending receipt of Certificate of Insurance corporation of Insurance provisions as shown, this contract is approved <br /> by the Risk Manager: (f_e V_W %&pr4e Cc <br /> Risk Manager's Signature: ?Date: V <br /> °l►1°I <br /> Financial Services <br /> This Contract is conditioned pon appropriation by the Board of Commissioners Yes❑ .No A budget amendment is necessary <br /> before approval Yes❑ No[. 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: q <br /> Financial Services Director's Signature: <br /> �(ia�MUJ ^� Date: (.3 <br /> 91<-13 <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 Manag r (Most other contracts$1,000 and above). Department Director approval only❑ (Under <br /> $1,000). This contract has be re i wed ved by the Attorney as to legal form and suffici ncy: <br /> Attorney's Signature Date:—0tt, <br /> County Manager <br /> This contract has been reviewed and is approved by qCI ger Yes No❑. <br /> This contract has been reviewed and is for signature ❑No <br /> Manager's Signature: Date: <br /> he 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 />