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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: A Helping Hand Party/Vendor Contact Person: Jennifer Ashley Contact Phone: Party/Vendor Address: <br /> 1502 W NC 54,Ste 405 City Durham State:NC Zip:27707 Department:Aging Amount: 8,000.00 Purpose: Caregiver Respite <br /> Budget Code(s): 10432020-630104 Vendor#32018 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract <br /> Type: (Check one)New❑ Renewal® Amendment ❑ Effective Date 07/01/14 Approved by Board Yes❑No❑ Agenda Date: <br /> Title of Contract:Caregiver Respite <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: T- P-/y <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 ❑. Hold <br /> Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as shov ued <br /> by the Risk Manager: <br /> Risk Manager's Signature: �_r--- Date: 11W AUG – 04 <br /> Financial Services <br /> This Contract is conditioned hon appropriation by the Board of Commissioners Yes❑No A budhkalkield, °• <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 Bud et and Fiscal Control Act: j <br /> Financial Services Director's Signature: C .Y. /� • �1.� Date: <br /> en <br /> County Attorney <br /> Approval by Board ❑ (Contracts $90,000.0 or more for goods or services, $250,000.00 or more for construction, or any BOCC <br /> consultant contract). Approval by ManagerX(Most other contracts$1,000 and above). Department Director approval only❑ (Under <br /> $1,000). This contract has been revi and approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: <br /> Count MY anager <br /> This contract has been reviewed and is approved by the County Manager YesNNo❑. <br /> This contract has been reviewed and is for signature by the Chair Yes❑No❑. <br /> Manager's Signature: Date: `t <br /> Clerk to the Board <br /> Approved by BOCC on the day of 120 Submitted for Chair signature on the—day of 120 <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />