Orange County NC Website
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: Kelly Brinn Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: 6623 Hamlett <br /> Road City Mebane State:NC Zip:27302 Department:Aging Amount: $4,560.00 Purpose: Senior Center Classes Budget Code(s): <br /> 10430120-629000 Vendor#59966 (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 forbid 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 show <br /> by the Risk Manager: I) <br /> Risk Manager's Signature: Date: JUN 2 0 2014 <br /> Za <br /> Financial Services <br /> This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No� A bud <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: M Date: <br /> County Attorney <br /> Approval by Board ❑ (Contracts $90,000.0 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 only❑(Under <br /> $1,000). This contract has bee reviewe nd approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: Z �� <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager YesB No❑. <br /> This contract has been reviewed and1s focignatule the Chair Y j❑No❑. <br /> Manager's Signature: r` f Date: _ <br /> c <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 />