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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: Music and Dance Productions,Inc Party/Vendor Contact Person: Debra Ramsey Boz Contact Phone: <br /> Party/Vendor Address:P O Box 728 City Franklinton State:NC Zip:27525 Department:Aging Amount: $1,200.00 Purpose:Dance <br /> Classes at the Seymour Center Budget Code(s): 10430120-629000 Vendor#61488 (N/A if new vendor) Vendor is a BOCC <br /> consultant? Yes❑No® Contract Type: (Check one)New❑ Renewal ® Amendment ❑ Effective Date 10/01/13 Approved by <br /> Board Yes❑No❑ Agenda Date: Title of Contract: Senior Center Instructor <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: 9•,7.5-/,j <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; ❑ ProfessionaI; ❑ Property; OR No Insurance Required ❑. Hold <br /> Contract pending receipt of Certificalf of Insurance ❑. With incorporation of Insurance provisions as shown,this contract is approved <br /> by the Risk Manager: t,J� <br /> Risk Manager's Signature: _ Date: Z6 o'er <br /> 101 1S <br /> Financial Services <br /> This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No[l/ 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 /> Financial Services Director's Signature: Date: ` ,0 / 3 <br /> 101 <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 E](Under <br /> $1,000). This contract has be tevie and approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature d Date: l 1 <br /> County Manager <br /> This contract has been reviewed and is a pro d by the Coun Manager Yes No❑. <br /> This contract has been reviewe d is r s' n t the air s❑No❑. <br /> v <br /> Manager's Signature: Date: <br /> Clerk to the Board <br /> Approved by BOCC on the_day of 120 Submitted for Chair signature on the day of 20 <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />