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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 t+ie Manager <br /> determines the contract is not appropriate for Manager approval the Manager shall submit the contract for BOCC ipproval. Contracts for <br /> BOCC approval must be submitted through,and complete,the routing process prior to agenda review. Contracts for legal ncyie\, should <br /> be completed through the legal review process prior to being routed for signature. <br /> Department <br /> Party/Vendor Name: Kathleen Hammon Party/Vendor Contact Person: Contact Phone: Party/Vendor Address 1 102 E. <br /> Franklin Street City Chapel Hill State:NC Zip:27514 Department:Aeipg Amount: $4,000.00 Purpose:Wellness Classes Budget <br /> Code(s): 10430120-770105 Vendor#56311 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No[g Contract l N pe: <br /> (Check one)New ❑ Renewal® Amendment ❑ Effective Date 07/01/2014 Approved by Board Yes❑No Agenda Date: <br /> Title of Contract: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 1,)i rector as to <br /> technical content: <br /> Department Director's Signature: Date: 7-1(,-1q, <br /> IT Director <br /> (Applicable only to hardware/software 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 Management <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 sho iL contr4c_t_is angroy ed <br /> by the Risk Manager: D <br /> Risk Manager's Signature: .4 Date:Z 71J!4 JUL 14 <br /> �Izt <br /> Financial Services <br /> This Contract is conditioned t on appropriation by the Board of Commissioners Yes❑No A bud %amendment is necessary <br /> before approval Yes❑No If budget amendment is necessary,please attach to this form. This instrument ai een prit-aLid;ie m t e <br /> manner required by the Local Government Budget/and Fiscal Con tro Act: J <br /> Financial Services Director's Signature: Al_ 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 by Manag [(Most other contracts$1,000 and above). Department Director approval only ❑ (Under <br /> $1,000). This contract has been reviewed approved by the Attorney as to legal form and sufficiency- <br /> Attorney's Attorney's Signature Date: 14- <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Yes[:]No[]. <br /> This contract has been reviewed and is for sign*u`rree by the Chair Yes❑No❑. <br /> Manager's Signature: <br /> r? '� 1 Date: / � � <br /> r <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 />