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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: Stephen Somers Party/Vendor Contact Person: Stephen Somers Contact Phone: Party/Vendor Address: <br /> 1162 Double Pond Lane City High point State:NC Zip:27265 Department: Library Amount: 360 Purpose:Programming Budget <br /> Code(s): 10500020-630000 Vendor#62182 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: <br /> (Check one)New® Renewal ❑ Amendment ❑ Effective Date Approved by Board Yes❑No® Agenda Date: <br /> Title of 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 nu er This contr t has been reviewed and approved by the Department Director as to <br /> technical content: <br /> Department Director's Signature: Date: <br /> rector <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 Z. 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 upon 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 Budget <br /> /pand__Fiscal Control Act: <br /> Financial Services Director's Signature: Mlt G Date: #170 <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 y 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 v'ew n approved by the Attorney as to legal form and sufficienc <br /> Attorney's Signature Date: t <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Yes[]No®. <br /> This contract has been reviewed and is for signature by the Chair Yes❑No®. <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 />