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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: Avis Barnes Party/Vendor Contact Person: Avis Barnes Contact Phone: Party/Vendor Address: 3113 <br /> Genlee Drive City Durham State:NC Zip:27704 Department: Public Health Amount: $500.00 Purpose: Provider will assist OCHD to <br /> implement the Carrboro High School Tobacco. Reality.Unfiltered. (TRU)Group Budget Code(s): 10412020-630000 Vendor#52313 <br /> (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one)New❑ Renewal ® Amendment <br /> ❑ Effective Date September 1,2014 Approved by Board Yes❑No❑ Agenda Date: September 1,2014-July 31,2015 Title of <br /> Contract: TRU Club Advisor AB <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: IUD�6 <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 show i-�CJT I a�r�e <br /> by the Risk Manager: ILS� 1155 <br /> Risk Manager's Signature: Date: AUG 2 8 2014 <br /> 8f� <br /> Financial Services By <br /> This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No[ A budget amendment is necessary <br /> before approval Yes[]No&. 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: Date: 17 I T <br /> 9L:3 <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 aqy,BOCC <br /> consultant contract). Approval by anager❑ (Most other contracts$1,000 and above). Department Director approval only (Under <br /> $1,000). This contract has been rek1hyed and 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 />