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.?OL4— =_�(4n <br /> ORANGE COUNTY-CONTRACT CONTROL SHEET <br /> Routing Order: (1)Department, (2)IT,(3)Risk Management, (4)Financial Services,(5)Attorney,(6)Manager,(71 ('1(:-k <br /> k <br /> This Document shall accompany all contracts and shall be submitted for signature in the Routing Order specified above. It thy 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 r:,. c.,\ should <br /> be completed through the legal review process prior to being routed for signature. <br /> Department <br /> Party/Vendor Name: U.S. Tae Kwon Do Center, Inc. Party/Vendor Contact Person: Steve Kim Contact Phone: (919)73(,-,!,k)' <br /> Party/Vendor Address: 15201 Rose Garden Lane City Durham State:NC Zip: 27707 Department: DEAPR Amount: $50! ,� (n t <br /> Purpose: Tae Kwon Do Instruction Budget Code(s): Vendor#61681 (N/A if new vendor) Vendor is a BOCC con,Ot.int? Yes <br /> ❑No® Contract Type: (Check one)New ® Renewal❑ Amendment ❑ Effective Date 7/1/2014 Approved by Board l s❑No <br /> ❑ Agenda Date: Title of Contract: Tae Kwon Do Instruction <br /> If this is a Grant Agreement, pre-application has been approved by the Board of Commissioners Yes❑No❑. If submitte._i too hid were <br /> bids/RFPs received Yes❑No❑ Bid/RFP number This contract has been reviewed and approved by the Department I Nvctor as to <br /> technical content: <br /> Department Director's Signature: Date: . 12 4-:— <br /> IT Director <br /> (Applicable only to hardware/software purchases or related services)This contract has been reviewed and approved by the I n turmation <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 Insur e li't:i" D, <br /> Contract pending receipt of Certificate of Insurance E]. With incorporation of Insurance provisions as shown o act is ipio ' ^I <br /> by the Risk Manager: <br /> JUl 014 <br /> Risk Manager's Signature: Date: Z71131 <br /> '717 By � <br /> Financial Services <br /> This Contract is conditioned ypon appropriation by the Board of Commissioners Yes❑No[q' A budget amendmeni necessary <br /> before approval Yes❑Noy. If budget amendment is necessary,please attach to this form. This instrument has been pre mid itcd in the <br /> manner required by the Local Government Budget andFiscal Control Act: 1 <br /> Financial Services Director's Signature: U"4A, Date: `l <br /> '11'1 <br /> County Attorney <br /> Approval by Board ❑ (Contracts $90,000.00 or more for goods or services, $250,000.00 or more for construction, )i , \ BOCC <br /> consultant contract). Approval by Manager Most other contracts$1,000 and above). Department Director approval pan [] (Under <br /> $1,000). This contract has been reviewed and approved 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 YesPNo❑. <br /> This contract has been reviewed and is or-�tg`n at we b <br /> Cha ir air� Yes❑No❑. <br /> Managers Signature. <br /> � 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 />