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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: James Wise Party/Vendor Contact Person: James Wise Contact Phone: 919-380-1042 Party/Vendor Address: <br /> 2324 Woodbury Drive City Hillsborough State:NC Zip:27278 Department: Public Health Amount: $500.00 Purpose: Provider will <br /> assist OCHD to implement the Chapel Hill High School Tobacco.REality.Unfiltered.(TRU) Budget Code(s): 10412020-630000 <br /> Vendor#603260 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type:(Check one)New ❑ Renewal <br /> ® Amendment ❑ Effective Date September 1,2014 Approved by Board Yes❑No❑ Agenda Date: September 1,2014-July <br /> 31,2015 Title of Contract: TRU Club Advisor JW <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: Date: <br /> IT rector <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 j 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: 7AU Risk Manager's Signature: � O� Date:8121 2014 <br /> Financial Services <br /> This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No❑�. A budg amendment is necessary <br /> before approval Yes❑No If budget amendment is necessary,please attach to this form. This instrument Ely 1 wa. pre. 911144ed in t! <br /> manner required by the Local Government Bud a aand®®Fiscal Contro Act: <br /> Financial Services Director's Si nature: ""`v'"L l �� Zz _ Date: <br /> g <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 an BOCC <br /> consultant contract). Approval by Manager El (Most other contracts$1,000 and above). Department Director approval only r'(Under <br /> $1,000). This contract has been review d approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: <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 /> Clerk to the Board <br /> Approved by BOCC on the_day of ,20 . Submitted for Chair signature on the_day of ,20 <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />