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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: Joy Gornto Party/Vendor Contact Person: same Contact Phone: Party/Vendor Address:3431 Pickett Road <br /> City Durham State:NC Zip:27705 Department:Aging Amount: $5,000 Purpose:wellness classes Budget Code(s):29430320-630000 <br /> Vendor#61228 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type: (Check one)New❑ Renewal <br /> ® Amendment ❑ Effective Date 07/01/14 Approved by Board Yes❑No® Agenda Date: Title of Contract: Wellness <br /> Instructor <br /> If this is a Grant Agreement,pre-application has been approved by the Board of Commissioners Yes❑Non. 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 shown <br /> by the Risk Manager: D <br /> Risk Manager's Signature: l/l. u- ,U• Date: ("//I I f y JUN 10 2014 <br /> Financial Services <br /> This Contract is conditioned on appropriation by the Board of Commissioners Yes❑Nov A budg d. <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: <br /> Financial Services Director's Signature: v, Date: b 1 r <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 0(Most other contracts$1,000 and above). Department Director approval only❑ (Under <br /> $1,000). This contract has bee viewe approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: 6 I g I+ <br /> County Manager <br /> This contract has been reviewed and is ap roved by the County Manager Yes lo❑- <br /> This contract has been reviewed an f i a e b t o Ch ' e 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 />