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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: The Exchange Club's Family Center in Alamance Party/Vendor Contact Person: Sarah Black Contact Phone: 336- <br /> 748-9028 Party/Vendor Address: 500 W.Northwest Blvd. City Winston-Salem State:NC Zip: 27105 Department: Finance&Admin. <br /> Services Amount: $2,000 Purpose: Performance Agreement Budget Code(s): 10495050-719069 Vendor#N/A (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: n� e <br /> Department Director's Signature: lf��"�``� Date: -141 <br /> T <br /> P g <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 F. With incorporation of Insurance provisions as shown,this contract is approved <br /> by the Risk Manager: <br /> Risk Manager's Signature: awe,__ r4 � Date: <br /> Financial Services <br /> This Contract is conditioned/pon appropriation by the Board of Commissioners Yes❑Nod 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: ge]jv('—w Date: <br /> 81Zo <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 bLvied %(Most other contracts$1,000 and above). Department Director approval only ❑ (Under <br /> $1,000). This contract has been r approved by the Attorney as to legal form and suffiQci ncy: <br /> Attorney's Signature Date: U 2� <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 forl2jenature by the Chair Yes❑No❑. <br /> Manager's Signature: Date: �( � <br /> Clerk to the Board <br /> Approved by BOCC on the_day of 20 itted for Chair signatuyrq o th (_day of 20 <br /> Clerk's Signature: <br /> Revised March 2012 <br />