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11?61_q_ .000 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: OCHD Party/Vendor Contact Person: Pascal Moore Contact Phone: 919-245-2460 Party/Vendor Address: 300 <br /> W.Tryon Street City Hillsboroueh State:NC Zip:27278 Department:Public Health Amount:N/A Purpose:= Budget Code(s):N/A <br /> Vendor#N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type:(Check one)New® Renewal❑ <br /> Amendment ❑ Effective Date March 1,2014 Approved by Board Yes[]No❑ Agenda Date: Title of Contract: <br /> Consolidated Agreement <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 's Signature: Date: <br /> IT Director <br /> (Applicable only to hardware/software ases or re a vices)This contract has been reviewed and approved by the Information <br /> Technology Director as to tec content and information technolog cations: <br /> IT Director s ignature: Date: <br /> Risk Management <br /> Include the following coverages: Auto; ❑ WC; ❑ Prof al; ❑ Property; OR No Insurance Required ❑. Hold <br /> Contract pending receipt of Certificate of Insuran Wit rporation of Insurance provisions as shown,this contract is approved <br /> by the Risk Manager: <br /> Risk Manager's Signat Date: <br /> Financial Services <br /> This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No A budge endment is necessary <br /> before approval Yes❑Nol V. 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: � "t"� �� f�"'- Date: Of <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 y BOCC <br /> consultant contract). Approval by Manager❑ (Most other contracts$1,000 and above). Department Director approval only I(Under <br /> $1,000). This contract has be n eview and approved by the Attorney as to legal form and sufficienc <br /> Attorney's Signature Date: <br /> �- <br /> Cou a er <br /> This contract has been reviewed and is approv my Manager Yes❑No❑. <br /> This contract has been reviewed and is for si re by the C�ai No[-]. <br /> Manager's Signature: a <br /> he <br /> Approved by BOCC on the_day of ,20 u mitte signature on the_day of ,20 <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />