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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 /> lerk <br /> This Document shall accompany all contracts and shall be submitted for signature in the Routing Order specified above. If Urc %tanager <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: Martha Hadden Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: 1.110 f fan$ <br /> Knoll City Chapel Hill State:NC Zip:27514 Department:Aging Amount: $990.00 Purpose: Wellness Classes Budget C odc(s): <br /> 29430320-630000 Vendor#61008 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type: ( heck one) <br /> New❑ Renewal® Amendment ❑ Effective Date 07/01/2014 Approved by Board Yes[:]No® Agenda Date:___ l'itle of <br /> 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 D.-partment Director as to <br /> technical content: <br /> Department Director's Signature: 4/, Date: <br /> IT Director <br /> (Applicable only to hardware/software purchases or related services)This contract has been reviewed and approv:d by the I r formation <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 [-I. Hold <br /> Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as sh r o Ir'tx a <br /> by the Risk Manager: D <br /> Risk Manager's Signature: Date: "2 i JUL 2 <br /> '71Z1 <br /> Financial Services <br /> This Contract is conditioned ton appropriation by the Board of Commissioners Yes❑No[2/ A b By ajiRm_iEiRFw—i+4. <br /> before approval Yes❑No[Y. If budget amendment is necessary,please attach to this form. This instrument haE been pre-audited in the <br /> manner required by the Local Government Budget and Fiscal Control Act <br /> Financial Services Director's Signature: C'�Jr'�"w L✓ ✓ . Ak4, 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 apy, BOCC <br /> consultant contract). Approval b anager❑ (Most other contracts$1,000 and above). Department Director approval on I y (Under <br /> $1,000). This contract has been vie ed and approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: -3 <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Yes[9io❑. <br /> This contract has been reviewed and is for signature by the Chair Yes❑No❑. <br /> Manager's Signature: lr `"r Date: t `7 <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 />