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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 the Manager <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: Stephanie Yost Party/Vendor Contact Person: Contact Phone: Party/Vendor Address:7700 <br /> Amesbury Drive City Chapel Hill State:NC Zip:27514 Department:Aging Amount: $5,000.00 Purpose: Wel ness Classes Budget <br /> Code(s):29430320-630000 Vendor#34784 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑Nogg Contract Type: <br /> (Check one)New❑ Renewal E] Amendment ❑ Effective Date 07/01/14 Approved by Board Yes❑Nod,' 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 Director as to <br /> technical content: <br /> Department Director's Signature: QAem�1,k/ Date: 7-AV 1Y <br /> IT Director <br /> (Applicable only to hardware/software 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 JO. Hold <br /> Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as shown,this contract is approved <br /> by the Risk Manager: <br /> Risk Manager's Signature: Date: h <br /> Financial Services <br /> This Contract is conditioned upon appropriation by the Board of Commissioners Yes❑Noy A budget amendment is necessary <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 Local Government Budget and Fiscal Control Act: <br /> Financial Services Director's Signature: 40acl 'j. A4141 Date: <br /> County Attornev <br /> Approval by Board ❑ (Contracts $90,009.90 or more for goods or services, $250,000.00 or more for construction, or any BOCC <br /> consultant contract).c=ovaiPWanager (Most other contracts$1,000 and above). Department Director approval only❑(Under <br /> $1,000). This contra be,� approved by the Attorney as to legal form and sufflc* <br /> ,�enc�:, <br /> Attorney's Signature Date: A <br /> County Manager ! <br /> This contract has been reviewed d is approved by the County Manager Yes 6<01,0, <br /> This contract has been reviewed and is FT or signature by the Chair YesMNo J U L 24 2 0174 <br /> Manager's Signature: Date: <br /> Clert rothe 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 />