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ORANGE CONTROL SHEET <br /> Routing Order: (|)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. lf the Manager <br /> determines the contract is not appropriate for Manager approval the Manager shall submit the contract for B0CCoppzovui 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 /> Purty/VeodnrNumo: Duke HomeCare&Hospice Party/Vendor Contact Person: Dale Horton Contact Phone:0l9-620-3853 <br /> Party/Vendor y� �byl��b�� �t����C Zip:27704 Department:Finance&Admin. Services <br /> Nuf�ose:Performance Agreement Budget Code(s): 10495050-710026 Vendor# 50707 (N/A if new vendor) Vendor is a <br /> Amount. e <br /> BOCC consultant? Yes Fj NoZ Contract Type: (Check one)New F-1 Renewal Z Amendment [] Effective Date 7/1/2014 <br /> Approved by Board Yeso NoF1 Agenda Date, 6/17/2014 Title of Contract:2014-15 Outside Agency Performance Agreement <br />� u this mu Grant Agreement, pre-application has been approved by the Board of Commissioners YenE]Noo. 1f submitted for bid were <br /> bidaDlFpo received YnsF�7VoFl Qid/8Fy number This contract has been reviewed and approved hy the Department Director uo0n <br /> technical content: <br /> Department Director's Signature: Date: <br /> IT Director <br /> (Applicable only m6ur6*uru6cftwo,e purchases or related services)This contract has been reviewed and approved hy the Information <br /> Technology Director as to technical content and information technology specifications: <br /> JT Director's Signature: Date: <br /> Risk Manaaemen <br /> Include the following coverages: F] CGL; F-1 Auto; r_1 VC; F� Professional; F� Property; OR No Insurance Required R. Hold <br /> Contract pending receipt of Certificate n[Insurance With incorporation ut Insurance provisions ua shown,this contract isapproved <br /> 6y the Risk Manager: <br /> Risk Manager's Signature: Date: 2�;� <br /> AUG 19 2014 <br /> Financial Services <br /> This Contract is conditioned on appropriation by the Board of Commissioners YesE]No2l/ A b t amendment is necessa <br /> If budget amendment is necessary,please attach to this form. This instrumeh"....b e... <br /> before approval YcsF�No-V <br /> manner required by the Local Government Budget Fiscal Control Act: <br /> Financial Services Director's Signature: Date: hy <br /> County Attornev <br /> Approval by Board 0 (Contracts $90,000)..Op or more for goods or services, $250,000.00 or more for construction, or any BOCC <br /> consultant contract). Approval b , Z (Most other contracts$1,000 and above). Department Director approval only r_1(Under <br /> $1,000). This contract has been ev* wed and approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature M — Date: <br /> If I County Manage <br /> This contract has been reviewed and is approved by the County Manager Y%4oa <br /> This contract has been reviewed and is f r signature by the Chair YesF�NoFl. <br /> Manager's Signature: Date: <br /> Clerk t9he Board <br /> Approved by BOCC on the_day of 20_. Submi hair signature on the Pay of 20__. <br /> Clerk's Signature: Date: fiv <br /> Revised March 2012 <br />