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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)Clerks <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: Orange Coupjy School System Party/Vendor Contact Person: Dr. Denise Morton Contact Phone: 919-732-8126 <br /> ext:12000 Party/Vendor Address: 200 East King St. City Hillsborough State:NC Zip:27278 Department: Public Health Amount: <br /> $232,055 Purpose:Provide funds to the School to support 3 FTE regi nurses Budget Code(s): Vendor#21981 (N/A if new <br /> vendor) Vendor is a BOCC consultant? Yes®No❑ Contract Type: C ecli one)New® Renewal E] Amendment ❑ Effective <br /> Date July 1,2013 Approved by Board Yes❑No❑ Agenda Date: 111111 Title of Contract: Agreement for School Nursing <br /> Services between OCHD and Orange County Schools <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 /> -57 <br /> Department Director's Signature: lwk, 4�_ 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: I <br /> ,( —isk Manf d.p�. vJ�t(�– - "'A <br /> Include the following coverages: WVCGL;' Auto; W WC; [jq Professional; Property; (nR No Insurance Required ❑. Hold <br /> Contract pending receipt of Certificate of Insurance ❑. With incorpordtion of Insurance pr visions as shown,this contract is approved <br /> by the Risk Manager: ..�`-=–�� "d .c.n <br /> I n <br /> Risk Manager's Signature: ae�- /� Date: <br /> °[LZLo <br /> Financial Services <br /> This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No A budget amendment is necessary <br /> before approval Yes[]No[ZIf 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 /> Financial Services Director's Signature: N.4-, fiAl_ Date: <br /> County Attorney <br /> Approval by Board 0 (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 ha b en r 'ew d and approved by the Attorney as to legal form and suffici cy <br /> Attorney's Signatur Date: 3 1� <br /> County Nlaaauer <br /> This contract has been reviewed and ' app r Wed by the County Nlarra-er Yes N o❑. <br /> This contract has been revie an 's for s' u by e ..air -s❑1\i�rJ. <br /> Manager's Signature- Date: <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 />