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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: Kerr Drug Inc Party/Vendor Contact Person: Mark J. Gregory Contact Phone: 919-544-3896 ext:143 <br /> Party/Vendor Address: 3220 Spring forest Road City Raleigh State:NC Zip: 27616 Department: Public Health Amount: 600 <br /> Purpose: Provider will implement the medications component of group instruction for the Orange Count D� SME Budget Code(s): <br /> 30412020-630000 71125 Vendor#59277 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type: (Check <br /> one)New® Renewal❑ Amendment ❑ Effective Date July 1,2013 Approved by Board Yes❑No❑ Agenda Date: <br /> Title of Contract: DSME-Kerr Health LLC <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 /> Department Director's Signature: Date: -;7 4 3 <br /> (Applica e on y o ar ases or related services)This contract has been reviewed an approve y e n orma ton <br /> Technology Director as to technical content and information ions: <br /> tree ors igna Date: <br /> Risk Management <br /> Include the following coverages: Q CGL; ❑ Auto; ❑ WC; Professional; ❑ Property; OR No Insurance Required ❑. Hold <br /> Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance rovtston as shown, this contract is approved <br /> by the Risk Manager: C _ _ f ) P�ec.,P <br /> Risk Manager's Signature: ` 1�.� _�! "�! Date: f� /� <br /> C � �- <br /> Financial Set vices <br /> This Contract is conditioned pon appropriation by the Board of Commission-rs 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 Budget and Fiscal Control Act: <br /> 7 <br /> Financial Services Director's Signature: Date: 1 I; <br /> lo1lo <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 d approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature _ _ Date: <br /> County Manage <br /> This contract has been reviewed and is approved by the County Manager Yes�lol❑. <br /> This contract has been review d nd for gnature by the iai• l'es!]No❑. <br /> C/ <br /> Manager's Signature: _ Date: <br /> Clerk to thu 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 />