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�-�Lt O RANGE COUNTY-CONTRACT CONTROL SHEET 6 Clerk <br /> Routing Order: (1)Department,(2)IT,(3)Risk Management,(4)Financial Services, (5)Attorney,O Manager,,(7) <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: Sarah Janet Whitesides,R.N. Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: <br /> 107 Center Street City Carrboro State:NC Zip:27510 Department: Aging Amount: $4.000.00 Purpose: Fit Feet clinic Budget <br /> Code(s):29430320-622000 Vendor#62174 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type: <br /> (Check one)New® Renewal ❑ Amendment ❑ Effective Date 10/21/13 Approved by Board Yes❑No[] Agenda Date: <br /> Title of Contract: Wellness 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: A'-,11-13 <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; ❑ Professional; ❑ Property; OR No Insurance Required ❑. 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: a:,� `.mac�,�.►e� Date: l r <br /> Financial Services <br /> This Contract is conditioned pon appropriation by the Board of Commissioners Yes❑No[ A budget amendment is necessary <br /> before approval Yes[]No 1. 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: 4. <br /> Financial Services Directors Signature: ''tMi► L� Date: <br /> 1110 <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 b anager 9(Most other contracts$1,000 and above). Department Director approval only❑ (Under <br /> $1,000). This contract has been ev e approved by the Attorney as to legal form and suffrci ncy: <br /> Attorney's Signature Date: t 7.0 <br /> County Manager <br /> This contract has been reviewed and is ap v y the County Manager Yes[ No❑. <br /> This contract has been reviewed s f r i a e he Y No❑. <br /> Manager's Signature: <br /> 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 />