R 2013-352 Finance - Marian Cheek Jackson Center Outside Agency

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ORANGE COUNTY—CONTRACT CONTROL SHEET Routing Order: (1)Department,(2)IT, (3)Risk Management,(4)Financial Services,(5)Attorney,(6)Manager,(7)Clerk This Document shall accompany all contracts and shall be submitted for signature in the Routing Order specified above. If the Manager determines the contract is not appropriate for Manager approval the Manager shall submit the contract for BOCC approval. Contracts for BOCC approval must be submitted through,and complete,the routing process prior to agenda review. Contracts for legal review should be completed through the legal review process prior to being routed for signature. Department Party/Vendor Name: Marian Cheek Jackson Center Party/Vendor Contact Person: Hudson Vaughn Contact Phone: Party/Vendor Address: 510 W. Rosemary St. City Chapel Hill State:NC Zip: 27516 Department: Finance and Administrative Services Amount: $4,500 Purpose: Outside Agency Budget Code(s): 10495050-719065 Vendor#N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one)New® Renewal ❑ Amendment ❑ Effective Date July 1,2013 Approved by Board Yes®No❑ Agenda Date: June 18,2013 Title of Contract: 2013-14 Outside Agency Performance Agreement If this is a Grant Agreement, pre-application has been approved by the Board of Commissioners Yes❑No❑. If submitted for bid were bids/RFPs received Yes❑No❑ Bid/RFP number This contract has been reviewed and approved by the Department Director as to technical content: Q Department Director's Signature: ' Date: p 27 3 IT Director (Applicable only to hardware/software purchases or related services)This contract has been reviewed and approved by the Information Technology Director as to technical content and information technology specifications: IT Director's Signature: Date: is Manageme`t Include the following coverages: [FCGL; 'Auto; WC; Professional; ❑ Property; OR No Insurance Required El. Hold Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as shown, this contract is approved by the Risk Manager: A-14. *•e-e& {.o A.A. - QC ct.S A-LcX i4c'^4LI i alb%-r+-J Ne-ecl (�� ess:•�.,Q nC-. we is b4-_l uLz lo%z4-Co►.n �c'E Risk Manager's Signature: �� V �„�.�— Date: 4 l3 } �` hQ vet to Uw Financial Services ¢ roor 006 This Contract is conditioned pon appropriation by the Board of Commissioners Yes❑Nov A budget amendment is necessary before approval Yes❑ No budget amendment is necessary,please attach to this form. This instrument has been pre-audited in the manner required by the Local Government Budget nd Fiscal Control Act: Financial Services Director's Signature: Date: �3 County Attorney Approval by Board ❑ (Contracts $90,000 00 or more for goods or services, $250,000.00 or more for construction, or any BOCC consultant contract). Approval y ana r X(Most other contracts$1,000 and above). Department Director approval only ❑ (Under $1,000). This contract has bee ev e d a oved by the Attorney as to legal form and sufficiency: Attorney's Signature C Date: 6 3 County Manager This contract has been reviewed and is ap ov by the Co my Manager Yes o❑. This contract has been reviewed is f si ur the air s❑No❑. Manager's Signature: Date: Orr Clerk to the Board Approved by BOCC on the_day of 20 . Submitted for Chair signature on the_day of 20 Clerk's Signature: Date: Revised March 2012