Orange County NC Website
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: Deborah B.Ballard Party/Vendor Contact Person: Deborah B.Ballard Contact Phone: Party/Vendor <br /> Address: 12 Mayapple Place City Durham State:NC Zip: 27705 Department:Public Health Amount: $200.00 Purpose: Provider will <br /> facilitate health literacy training for Healthy Carolinians of Orange County Budget Code(s): 10412020-630000—Vendor#N/A (N/A if <br /> new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type: (Check one)New® Renewal❑ Amendment ❑ <br /> Effective Date August 11,2014 Approved by Board Yes❑No❑ Agenda Date: August 11,2014-August 27,2014 Title of <br /> Contract: Health Literacv DB <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 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 Reguired <br /> Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as shown, t F cWQs�p�o <br /> by the Risk Manager: <br /> Risk Manager's Signature: Date: -2 2 AUG 2 8 2014 <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[] 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: VCG ✓ A IJOAA, Date: I I7[e <br /> l� <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 a ager[:] (Most other contracts$1,000 and above). Department Director approval only(Under <br /> $1,000). This contract has been re d and approved by the Attorney as to legal form and sufficiQen y: <br /> Attorney's Signature Date: t 8 <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 />