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o�l_-3- -q S() <br /> 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: Patterson Dental Party/Vendor Contact Person: Jim Hove Contact Phone: 919.614.5818 Party/Vendor Address: <br /> 6520 Meridian Dr# 132 City Raleigh State:NC Zip:27616 Department: Public Health Amount: $12,000 Purpose: Provider will <br /> upgrade existing software and other eServices described by Patterson Dental Budget Code(s): 61370035-800100-30012 Vendor#24726 <br /> (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one)New® Renewal ❑ Amendment <br /> ❑ Effective Date November 1,2013 Approved by Board Yes❑No❑ Agenda Date: Title of Contract: Patterson eServices <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: INW-13 <br /> (Applicable only to hardware/software purchases or related services)This contract has been revtewe <br /> Technology Director as to technical content and information technology specifications: <br /> IT a ure: Date: <br /> Risk Management <br /> Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required El. Hold <br /> Contract pending receipt of Certificate of Insurance ❑. With incorp ation of Insurance provisions as shown, this contract is approved <br /> by the Risk Manager: C'e <br /> Risk Manager's Signature: Date: J,tI4 '3 <br /> Financial Services <br /> This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No N 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: a�w //. Date: R lz Is <br /> County Attorney <br /> Approval by Board ❑ (Contracts $90,000 0 or more for goods or services, $250,000.00 or more for construction, or any BOCC <br /> consultant contract). Approval by Man a er P(Most other contracts$1,000 and above). Department Director approval only❑ (Under <br /> $1,000). This contract has be ev'ewe pproved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: I" <br /> County Manager <br /> This contract has been reviewed and is ve the ount Manager Yes o❑. <br /> This contract has been reviewed a fo i at a the it e 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 120 <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />