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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,(71( Jerk <br /> This Document shall accompany all contracts and shall be submitted for signature in the Routing Order specified above. b'the Manager <br /> determines the contract is not appropriate for Manager approval the Manager shall submit the contract for BOCC approval. e'ontracts 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: SECU Family House at UNC Hospitals Party/Vendor Contact Person: Kirsten Beattie Contact Phone y 1 9932- <br /> 8000 Party/Vendor Address: 123 Old Mason Farm Road City Chapel Hill State:NC Zip:27517 Department:EDC-Arts c,'oniinission <br /> Amount: $1,500 Purpose: Spring 2014 Arts Grants Agreements Budget Code(s): #37601020-683000 Vendor#61718 (N/A i f new <br /> vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type:(Check one)New® Renewal❑ Amendment [_] f:ffective <br /> Date date of last signature Approved by Board Yes®No❑ Agenda Date:June 17,2014 a(__pnroval of FYI budget) 'l ifle of <br /> Contract: Orange County Arts Commission Spring 2014 Grant Agreement <br /> If this is a Grant Agreement,pre-application has been approved by the Board of Commissioners Yes❑No❑. If submitted for hid were <br /> bids/RFPs received Yes❑No[] Bid/RFP number This contract has been reviewed and approved by the Department I)irector as to <br /> technical content: I Al <br /> Department Director's Signature: V", Date: 3 <br /> IT Director <br /> (Applicable only to hardwarelsoftware purchases or related services)This contract has been reviewed and approved by the I nformation <br /> Technology Director as to technical content and information technology specifications: <br /> IT Director's Signature: Date: <br /> Risk Manaeement <br /> Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Inst fFmaa R qui_cad <br /> Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as shoes ip jaui is app* v <br /> by the Risk Manager: <br /> n JUL � 4 <br /> Risk Manager's Signature: LAC _ o .�-�- Date: / <br /> Financial Services Y - <br /> This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No� A budget amendment is necessary <br /> before approval Yes❑NoM.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* A / <br /> Financial Services Director's Signature: t/l Date: ` <br /> .1l7 <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 anager (Most other contracts$1,000 and above). Department Director approval on Iy [.] (Under <br /> $1,000). This contract has been vi ed d p oved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: <br /> County Manager y <br /> This contract has been reviewed and is approved by the County Manager YesF/ No❑. <br /> This contract has been reviewed and is for signature by the Chair Yes❑No❑. <br /> � <br /> Manager's Signature: Date: <br /> Clerk to the Board <br /> Approved by BOCC on the_day of 120 Submitted for Chair signature on the_day of . 20 <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />