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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: UNC Center for Health Promotion and Disease Prevention Party/Vendor Contact Person: Randy Bickford Contact <br /> Phone:919-962-4680 Party/Vendor Address: 104 Airport Dr.,Ste 2200 City Chapel Hill State:NC Zip:27599 Department:Aline <br /> Amount: $9,900.00 Purpose:MAP Housing Study Budget Code(s): 10430020-630120 Vendor# 10419 (N/A if new vendor) Vendor <br /> is a BOCC consultant? Yes❑No❑ Contract Type: (Check one)New❑ Renewal® Amendment ❑ Effective Date 12/01/13 <br /> Approved by Board Yes❑No[] Agenda Date: Title of Contract:MAP Housing Studv <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; Ae-11-1_4 <br /> IT Director <br /> (Applicable only to hardwarelsoftware 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: �. ,` 1�2��s — Date: - <br /> lz � ii <br /> Financial Services <br /> This Contract is condi 'oned upon appropriation by the Board of Commissioners Ye&No❑. A budget amendment is necessary <br /> before approval Yes91 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.�i.,4✓ /A .�h�M� Date: L 1-T <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 Manager (Most other contracts$1,000 and above). Department Director approval only❑(Under <br /> $1,000). This contract has been rev i d and rov y the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: <br /> County Manager <br /> This contract has been reviewed and is ap ov by the County Manager YesErNoEl <br /> This contract has been reviewed s f r si a e t o it ❑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 />