Orange County NC Website
le <br /> ORANGE COUNTY—CONTRACT CONTROL SHEET <br /> Routing Order: (I)Department,(2)IT,(3)Risk Management,(4)Financial Services,(5)Attorney,(6)Manager,(7)Clerk <br /> This Document shaII 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: Michael Patterson Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: 1605 Cliff <br /> St City Durham State:NC Zip:27707 Department:Aging Amount: $960.00 Purpose:Movement Class and Personal Trainine Budget <br /> Code(s):29430320-630000 Vendor#62289 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type: <br /> (Check one)New® Renewal❑ Amendment ❑ Effective Date 04/04/14 Approved by Board Yes❑No® Agenda Date: <br /> Title of Contract: Wellness 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 4sho �cr e <br /> by the Risk Manager: /?Risk Manager's Signature: / �" 9 `'�- Date: APR 1 5 2014 <br /> Financial Services <br /> This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No(� A budge ame <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::', J <br /> Financial Services Director's Signature: Date: 1 'ILI <br /> 51'7 <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 Manager❑(Most other contracts$1,000 and above). Department Director approval onl (Under <br /> $1,000). This contract has bee eview d approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: 5 'l <br /> VV <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: 1 f r` 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 />