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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: Jane Shealy Party/Vendor Contact Person: Contact Phone: Party/Vendor Address:216 May Court <br /> City Chapel Hill State:NC Zip:27514 Department:Aging Amount: $3,000.00 Purpose: Senior Center Classes Budget Code(s): <br /> 10430120-629000 Vendor#N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type:(Check one) <br /> New® Renewal❑ Amendment ❑ Effective Date 07/01/14 Approved by Board Yes❑No❑ Agenda Date: Title of <br /> Contract:Senior Center 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: .-0• Date: W/-/9-/'f <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; ❑ ProfessionaI; ❑ Property; OR No Insurance Required Q. Hold <br /> Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as sh D i <br /> by the Risk Manager: <br /> Risk Manager's Signature: „!- d �,.��' Date: JUN 2 0 2014 <br /> LP l zs � <br /> Financial Services By <br /> This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No A b <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 Control Act:Fi (/ <br /> Financial Services Director's Signature: � 0� Date: <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 anagert (Most other contracts$1,000 and above). Department Director approval only❑(Under <br /> $1,000). This contract has bee I r ew an pproved by the Attorney as to legal form and sufficiency- <br /> Attorney's Signature Date: <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Yese No❑. <br /> This contract has been reviewed and is far signature by e Chair Yes❑No❑. <br /> Manager's Signature: Date: <br /> Q-.. <br /> " " Ierk to the Board <br /> Approved by BOCC on the,day of ,20 Submitted for Chair signature on the day of 120 <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />