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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. 11 the Nlanager <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 rep iew should <br /> be completed through the legal review process prior to being routed for signature. <br /> Department <br /> Party/Vendor Name: Senie Wolfe PartyNendor Contact Person: Contact Phone: Party/Vendor Address: 9Q9 Palmers <br /> Grove Church Road City Hillsborough State:NC Zip:27278 Department:Aging Amount: $2,400.00 Purpose Wellness Classes <br /> Budget Code(s): 10430120-770105 Vendor#58051 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑NoEl Contract <br /> Type: (Check one)New ❑ Renewal® Amendment ❑ Effective Date 07/01/2014 Approved by Board Yes❑NoZ Agenda <br /> Date: 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 I)irector as to <br /> technical content: <br /> Department Director's Signature: Date: 7-/(/f <br /> IT Director <br /> (Applicable only to hardware/software purchases or related services)This contract has been reviewed and appro-ed by the 111 formation <br /> Technology Director as to technical content and information technology specifications: <br /> IT Director's Signature: Date: <br /> Risk Management 041113- <br /> Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required D. Hold <br /> Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as shown h;c contrast.is approved <br /> by the Risk Manager: D 1 C' M (� <br /> Risk Manager's Signature: Date: 7 7 lU LI L5 <br /> '7lZi Jul 014 <br /> Financial Services <br /> This Contract is conditionedfpon appropriation by the Board of Commissioners Yes❑No[i/ A budge Eohendmert is necessary <br /> before approval Yes❑NoLM. If budget amendment is necessary,please attach to this form. This instrument has been pre=au"d4& m e <br /> manner required by the Local Government Budget and Control Act* <br /> Financial Services Director's Signature: `U 4." sue? � Date: / �Z <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 an' BOCC <br /> consultant contract). Approval by M er (Most other contracts$1,000 and above). Department Director approval on I (Under <br /> $1,000). This contract has been revi we and 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 YesgNo❑. <br /> This contract has been reviewed and is for signature by the Chair Yes❑No❑. <br /> Manager's Signature: Date: <br /> Jerk 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 />