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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: Community Empowerment Fund Party/Vendor Contact Person: Maggie West Contact Phone: 919-200-0233 <br /> Party/Vendor Address: 133 1/2 E.Franklin St., Suite 105 City Chapel Hill State:NC Zip: 27514 Department: Finance&Admin. <br /> Services Amount: $5,000 Purpose: Performance Agreement Budget Code(s): 10495050-719064 Vendor#61695 (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes❑No® Contract Type: (Check one)New❑ Renewal® Amendment ❑ Effective Date <br /> 7/1/2014 Approved by Board Yes®No❑ Agenda Date: 6/17/2014 Title of Contract:2014-15 Outside Agency Performance <br /> 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: .J Date: O �� <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 Mip3re-au roved <br /> by the Risk Manager: �Risk Manager's Signature: �( �/ per ---- Date:Financial Services <br /> This Contract is conditioned pon appropriation by the Board of Commissioners Yes❑No[� A cess ry <br /> before approval Yes❑ Zvrlf budget amendment is necessary, please attach to this form. This instr i e <br /> manner required by the Local Government Budget and FiscalControl ct: / <br /> Financial Services Director's Signature: XDa te: <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 by ger[a(Most other contracts$1,000 and above). Department Director approval only ❑ (Under <br /> $1,000). This contract has been revi w d and a proved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: 3 125L 4— <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Yes No❑. <br /> This contract has been reviewed and is for signature by the Chair Yes❑No❑. <br /> Manager's Signature: Date: <br /> C7 <br /> Clerk to t1w Board <br /> Approved by BOCC on the day of 120 d for Chair signature on the da of ,20 <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />