R 2014-267 DEAPR for tae kwon do instruction

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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: U.S. Tae Kwon Do Center,Inc. Party/Vendor Contact Person: Steve Kim Contact Phone: (919)730-3697 Party/Vendor Address: 15201 Rose Garden Lane City Durham State:NC Zip:27707 Department: DEAPR Amount: $996.00 Purpose: Tae Kwon Do Instruction Budget Code(s): Vendor#61681 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No ® Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date 3/16/2014 Approved by Board Yes❑No❑ Agenda Date: Title of Contract: Tae Kwon Do Instruction 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 Director (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 Management Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required ❑. Hold Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as show ig-:c - act i�apprcZ by the Risk Manager: LL55 lJ 2 BUT Risk Manager's Signature: 0 Date: JUN — 3 2014 Financial Services B �� Y This Contract is conditioned pon appropriation by the Board of Commissioners Yes❑No A budg before approval Yes❑ No 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 Contr�I Act: �p Financial Services Director's Signature: YC�G..P✓ .//. Date: 1� "� 4 / County Attorney Approval by Board ❑ (Contracts $90,000.00 or more for goods or services, $250,000.00 or more for construction, or any BOCC consultant contract). Approval by Manager❑ (Most other contracts $1,000 and above). Department Director approval only nder $1,000). This contract has beep review pproved by the Attorney as to legal form and sufficiency: Attorney's Signature Date: G- lo-1v County Manager This contract has been reviewed and is ap rove y the County Manager Yes No❑. This contract has been reviewed s f sig a re e 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