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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: Orange County Rape Crisis Center Party/Vendor Contact Person: Shamecca Bra Contact Phone: 919-968-4647 <br /> Party/Vendor Address: PO Box 4722 City Chapel Hill State:NC Zip:27515 Department: Finance&Admin. Services Amount: <br /> $30,000 Purpose: Performance Agreement Budget Code(s): 10495050-710009 Vendor#800015 (N/A if new vendor) Vendor is a <br /> BOCC consultant? Yes❑No® Contract Type: (Check one)New❑ Renewal ® Amendment ❑ Effective Date 7/1/2014 <br /> Approved by Board Yes®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 /> A Department Director's Signature: Date: Zl <br /> IT Director <br /> (Applicable only to hardwarelsoftware 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, this contract is approved <br /> by the Risk Manager: <br /> Risk Manager's Signature: �p „%a C 11 <br /> 81 <br /> Financial Services <br /> This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No[� A budget amendment is necessary <br /> before approval Yes[:] NoM.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 Act: <br /> Financial Services Director's Signature: N`(4- W Date: z <br /> 81Z0 <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 Ma g X(Most other contracts$1,000 and above). Department Director approval only ❑ (Under <br /> $1,000). This contract has been revie e a d approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: 4711 <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Yesff No❑. <br /> This contract has been reviewed and is si ture by e Chair Yes❑No❑. <br /> Manager's Signature: Date: <br /> Clerk to th oard <br /> Approved by BOCC on the_day of 20 u i ed f r Chair signature on the da of 20 <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />