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7Z <br /> 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 the Manager <br /> determines the contract is not appropriate for Manager approval the Manager shall submit the contract for BOCC afproval. 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: Toni Campbell Shaw Party/Vendor Contact Person: same Contact Phone: Party/Vendor Address: 1301 <br /> Deerfield Trace City Mebane State:NC Zip:27302 Department:Aging Amount:$2,400.00 Purpose:Wellness Class Budget Code(s): <br /> 29430320-630000 Vendor#61838 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type:(Check one) <br /> New❑ Renewal® Amendment ❑ Effective Date 07/11/14 Approved by Board Yes❑No® Agenda Date: Title 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 Department Director as to <br /> technical content: <br /> Department Director's Signature: Date: ///'f <br /> IT Director <br /> (Applicable only to hardwarelsoftware purchases or related services)This contract has been reviewed and approved by the Information <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 ❑. With incorporation of Insurance provisions as show <br /> by the Risk Manager: rrz <br /> Risk Manager's Signature: Date: JUL 11 2014 <br /> �r[,y <br /> Financial Services 74>L4-\ <br /> This Contract is conditioned upon appropriation by the Board of Commissioners Yes❑No❑. A budlLy <br /> before approval Yes❑No❑. If budget amendment is necessary,please attach to this form. This instrument has been pre-audited in the <br /> manner required by the LocaAS.v ent Budget and Fisc Control <br /> Financial Services Director A�korv_114V'3�t Date: '7 It• <br /> ©! 1R <br /> County Attorney <br /> Approval by Board ❑ (Contracts $90,0001- 0 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 only El (Under <br /> $1,000). This contract has been r v' ed 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 Yes B No❑. <br /> This contract has been reviewed and for si atur by the Chair Yes❑No❑. <br /> f <br /> Manager's Signature: �� 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 />