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-'^% l4-fit <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: Nina Maier Party/Vendor Contact Person: same Contact Phone: Party/Vendor Address: 3302 Pearson Rd <br /> City Hurdle Mills State:NC Zip:27541 Department:Asigg Amount: $4,500 Purpose:wellness classes Budget Code(s):29430320- <br /> 630000 Vendor#51178 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type:(Check one)New❑ <br /> Renewal ® Amendment ❑ Effective Date 07/01/14 Approved by Board Yes❑No® Agenda Date: Title of Contract: <br /> 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: 6-f-lY <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 Mana¢ement <br /> Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required [ Hold <br /> Contract pending receipt of Certificate of Insurance E]. With incorporation of Insurance provisions as sh io app <br /> by the Risk Manager: D <br /> Risk Manager's Signature:��.r'iv�t, �� �M�-. Date: &/I JUN 10 2014 <br /> Financial Services By <br /> This Contract is conditioned on appropriation by the Board of Commissioners Yes❑NoG2( A bu tS <br /> before approval Yes❑No[ 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: k1—w J4,4—)- Date: t' <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 tZ(Most other contracts$1,000 and above). Department Director approval only❑ (Under <br /> $1,000). This contract has bei n evie d d approved by the Attorney as to legal form and sufficiency:41'41+ <br /> Attorney's Signature Date: <br /> County Manauer�, � <br /> This contract has been reviewed and is a pro d the County Manager Yesli KEI <br /> This contract has been reviewed an ' or s. a e y the C it N <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 /> i <br />