R 2014-112 Health - Recreation Factory Partners Provide matching fund to OCHD Innovation Grant for 50% of purchase prices

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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: Recreation Factory Partners Party/Vendor Contact Person: John Stock Contact Phone:919-644-0339 ext222 Party/Vendor Address: 101 Meadowlands Drive City Hillsborough State:NC Zip:27278 Department: Public Health Amount: $1,700 Purpose: Provide matching funds to the OCHD Innovation Grant for 50%of purchase prices Budget Code(s): 10410020-680030 Vendor #800002 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type: (Check one)New® Renewal ❑ Amendment ❑ Effective Date January 1,2014 Approved by Board Yes❑No❑ Agenda Date: Title of Contract: SportsPlex Oven 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: Department Director's Signature: Date: IT irector (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:_ Risk Manazement Include the following coverages: ❑ CGL; ❑ 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: Risk Manager's Signature: Date: 3 Financial Services This Contract is conditioned ppon appropriation by the Board of Commissioners Yes❑No[Y A budget amendment is necessary before approval Yes❑ NoZ. If budget amendment is necessary, please attach to this form. This instrument has been pre-audited in the manner required by the Local Government Budget and'Fiscal Control Act- r Financial Services Director's Signature: lX �"� _Date: 1 S t1l,+ County Attorney Approval by Board ❑ (Contracts $90,0001010 or more for goods or services, $250,000.00 or more for construction, or any BOCC consultant contract). Approv by Manage (Most other contracts$1,000 and above). Department Director approval only ❑ (Under $1,000). This contract has be n evie a approved by the Attorney as to legal form and suffici ncy: Attorney's Signature Date: 1 County Manager This contract has been reviewed and is pro d by the County Manager Yes /No[o. This contract has been reviewed is si ture he Y No❑. Manager's Signature: Date: 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