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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: Charles House Association Party/Vendor Contact Person: Paul Klever Contact Phone: 919-967-7570 <br /> Party/Vendor Address: 109 Hillcrest Avenue City Carrboro State:NC Zip:27510 Department: Finance&Admin. Services Amount: <br /> $15,000 Purpose:Performance Agreement Budget Code(s): 10495050-710029 Vendor#800031 (N/A if new vendor) Vendor is a <br /> BOCC consultant? Yes E]NoN Contract Type: (Check one)NewEJ Renewal E Amendment ❑ Effective Date 7/1/2014 <br /> Approved by Board YesZ No❑ Agenda Date:6/17/2014 Title of Contract:2014-15 Outside Agency Performance Agreement <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: Wjj�,fX, Date: 0 (2 <br /> A4 1+ <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 R. With incorporation of Insurance provisions as sh v d <br /> by the Risk Manager: <br /> as ved <br /> s s <br /> Risk Manager's Signature: � k Date: '? <br /> ''lu AUG 18 2014 <br /> Financial Services <br /> This Contract is conditioned Aon appropriation by the Board of Commissioners Yes❑Now Ab <br /> - <br /> before approval Yes❑NorO. If budget amendment is necessary,please attach to this form. This instrument has been leis <br /> -audited in t e <br /> manner required by the Local Government Budget and Fiscal Control Act: <br /> Financial Services Director's Signature:_Nye ..t,4- A AAAo- l Date: �Pl 14 <br /> County Attorney <br /> Approval by Board E] (Contracts $90,000.00 or more for goods or services, $250,000.00 or more for construction, or any BOCC <br /> consultant contract). Approval by,44anagero(Most other contracts$1,000 and above). Department Director approval only❑ (Under <br /> $1,000). This contract has been r vi ed roved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: <br /> County Manage <br /> This contract has been reviewed and is approved by the County Manager Yes Wl NoR. <br /> This contract has been reviewed and is for signature by the Chair Yes❑No❑. <br /> 12 <br /> Manager's Signature- / 7 Date: <br /> Clerk to the Aard <br /> Approved by BOCC on the_day of 20__. Submit hair signature on th� y of 120 <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />