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1-4 -J455 <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 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: Cindy Evans Party/Vendor Contact Person: Cindy Evans Contact Phone: Party/Vendor Address:264 Osee <br /> Rd City Sparta State:NC Zip:28675 Department:Public Health Amount: $3,200.00 Purpose:Provider will assist OCHD by <br /> providing Accounting Specialist services Budget Code(s): 10410020-630000 Vendor#NA (N/A if new vendor) Vendor is a BOCC <br /> consultant? Yes❑No® Contract Type: (Check one)New® Renewal❑ Amendment ❑ Effective Date August 19,2014 <br /> Approved by Board Yes❑No❑ Agenda Date:August 19,2014-November 3,2014 Title of Contract: OCHD AR CEVANS <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 /> r <br /> Department Director's Signature: Date: Y <br /> IT irector <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 shown, <br /> by the Risk Manager: D <br /> Risk Manager's Signature: �� l Date: B AUG 2 �O 2014 <br /> S 1 Z.1 <br /> Financial Services �- <br /> This Contract is conditioned goon appropriation by the Board of Commissioners Yes❑Nov A budget B <br /> before approval Yes❑NoLV. 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 A t: 1 <br /> Financial Services Director's Signature: (44lik JJ, /d _ Date: / <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 any BOCC <br /> consultant contract). Approval Manager 1214Most other contracts$1,000 and above). Department Director approval only❑(Under <br /> $1,000). This contract has bee re 'ew 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 o❑. <br /> This contract has been reviewed and is for 7' natur by the Chair Yes❑No❑. <br /> g <br /> er <br /> Mana g 's Signature: /// Date: <br /> Clerk to the Board <br /> Approved by BOCC on the_day of ,20 mitte for Chair signature on the ay of ,20 <br /> Clerk's Signature: Date: L �- <br /> Revised March 2012 <br />