Orange County NC Website
a?�l -18(4 <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: Reed M Davis Party/Vendor Contact Person: Contact Phone: Party/Vendor Address:2901 Shagbark <br /> Lane City Graham State:NC Zip:27253 Department:Aging Amount:1500.00 Purpose:Clogging Instructor Budget Code(s): <br /> 10430120-629000 Vendor#62405 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type:(Check one) <br /> New® Renewal ❑ Amendment ❑ Effective Date 04/04/14 Approved by Board Yes❑No® Agenda Date: Title of <br /> Contract: Senior Center Instructor <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: <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 <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 sho ,D i�c <br /> by the Risk Manager: <br /> Risk Manager's Signature: �. i,� Date: / APR 1 1 2 014 <br /> Financial Services gy <br /> This Contract is conditioned pon appropriation by the Board of Commissioners Yes❑NoE/ A bud <br /> before approval Yes[:]NoF 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: l <br /> Financial Services Director's Signature: & A, /�, Date: <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 BOCC <br /> consultant contract). Appr a y Manager❑ (Most other contracts$1,000 and above). Department Director approval only (Under <br /> $1,000). This contract has en viewed and approved by the Attorney as to legal form and sufficiency: / <br /> Attorney's Signature Date: Zd I (Z, <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 />