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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: James Wise 1PartyNendor Contact Person: James Wise Contact Phone: 919-380-1042 Party/Vendor Address: <br /> 2324 Woodbury Drive City Hillsborough State:NC Zip:27278 Department: Public Health Amount: $500.00 Purpose: Provider will <br /> work with OCHD with the 2013-2014 TRU Club Advisor program Budget Code(s): 10412020-630000 Vendor#603260 (N/A if new <br /> vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type:(Check one)New® Renewal❑ Amendment ❑ Effective <br /> Date September 1,2013 Approved by Board Yes[]No❑ Agenda Date: Title of Contract: TRU Club Advisor <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❑Nor-] 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: ► - l� <br /> etr <br /> "'Z only to hardware/software purchases or related services)This contract has been reviewed and approve y <br /> Technology Director as to—re—chmee s ecifications: <br /> If 091 ectul's %gftfttHiT_. _ <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: W ft,'1-'--d- uC g"%-sa( <br /> Risk Manager's Signature:_, Z Date: <br /> 1zim <br /> Financial Services <br /> This Contract is condi ' ned upon appropriation by the Board of Commissioners Yes[jNo[]. A budget amendment is necessary <br /> before approval Yes2No❑. 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 Bud a and Fiscal Control Acct:: J <br /> Financial Services Director's Signature: l�►. +�` J 4— Date: tZ S-1 1.3 <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 be r view an approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: <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 />