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V�- <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 iManager 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: Jan E.Jackson Party/Vendor Contact Person: Jan E.Jackson Contact Phone: Party/Vendor Address: 129 <br /> Azalea Ave City Roxboro State:NC Zip:27573 Department: Public Health Amount: $6,000 Purpose:Provider will enforce Food. <br /> Lodging and Institutional Sanitation laws and rules Budget Code(s): 10413020-630000 Vendor#N/A (N/A if new vendor) Vendor is <br /> a BOCC consultant? Yes❑No® Contract Type:(Check one)New® Renewal❑ Amendment ❑ Effective Date August 6,2013 <br /> Approved by Board Yes❑No❑ Agenda Date: Title of Contract: 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 /> C � <br /> Department Director's Signature: Date: - <br /> (App r l to hardware/so are purchases or relates/se rO e;)This contract has been reviewed and approved by the Information <br /> Technology Director as content and information recl:nology specifications: <br /> it e: _ <br /> Risk Management <br /> Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required 47. 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: Date: <br /> Financial Services <br /> This Contract is conditioned Vpon appropriation by the Board of Commissioners Yes❑Now A budget amendment is necessary <br /> before approval Yes❑Nolf 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 /> �m� lJ q 3 <br /> Financial Services Director's Signature: _ � Date: <br /> CountlAtlornev <br /> Approval by Board ❑ (Contracts $90,00 004 more for goods or services, $250,000.00 or more for construction, or any BOCC <br /> consultant contract). Appr 1 by anager ost other contracts$1,000 and above). Department Director approval only❑(Under <br /> $1,000). This contract has ee re a and proved by the Attorney as to legal form and suffi(c�iency: <br /> Attorney's Signature Date: ` 3 <br /> i <br /> County Manager <br /> This contract has been reviewed and is approved th ounty Manager es❑N [I.This contract has been reviewed and i sign e e a. Yes o❑. <br /> Manager's Signature: Date: b <br /> Clerk to the Board <br /> Approved by BOCC on the^day of Submitted for Chair signature on the �day of -20 <br /> Clerk's Signature: _Date: <br /> Revised March 2012 <br /> f <br />