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cote} -tez <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: U.S. Tae Kwon Do Center,Inc. PartyNendor Contact Person: Steve Kim Contact Phone: (919)730-3697 <br /> Party/Vendor Address: 15201 Rose Garden Lane City Durham State:NC Zip: 27707 Department:DEAPR Amount: $3925.20 <br /> Purpose: Tae Kwon Do Instruction Budget Code(s): Vendor#61681 (N/A if new vendor) Vendor is a BOCC consultant? Yes <br /> ❑ <br /> No Contract Type:(Check one)New ® Renewal❑ Amendment ❑ Effective Date 1/14/2014 Approved by Board Yes❑ <br /> Non Agenda Date: Title of Contract: Tae Kwon Do Instruction <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: i 123)14— <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 ?j <br /> Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Require Hold f <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: � Date: //49..oZ-,'rf/SD <br /> Financial Services <br /> This Contract is conditioned Won appropriation by the Board of Commissioners Yes❑No[� 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: �/ �p <br /> Financial Services Director's Signature: aW�G�-4", J. Ji__.- Date: f(20�( 1 <br /> lt ..2•(l4 <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 Manage, a ost other contracts$1,000 and above). Department Director approval only ❑ (Under <br /> $1,000). This contract has been reviewed• an. .,'roved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature G -- Date: <br /> /-3 /f <br /> County Manager <br /> This contract has been reviewed and 's approved • the County Manager Yes o❑. <br /> ifThis contract has been reviewed .••, for •n- ,e by the ha 1`des I,Oa <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 />