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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: Shari Covenev Party/Vendor Contact Person: Shari Covenev Contact Phone: Party/Vendor Address: 1622 <br /> Worth Street City Hillsborough State:NC Zip:27278 Department:Public Health Amount: $500.00 Purpose: Provider will assist <br /> OCHD to implement the Carrboro Huh School Tobacco Reality.Unfiltered.(TRU)Group Budget Code(s): 10412020-630000 Vendor <br /> #62244 (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 /> 2015 Title of Contract: TRU Club Advisor SC <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: �'� 'I q <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 Mana¢ement <br /> Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required E. Hold <br /> Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as showi 1,D tcgc I aTrr <br /> by the Risk Manager: LC l�r <br /> Risk Manager's Signature: Date: / AUG 2 8 2014 <br /> Financial Services By <br /> This Contract is conditioned y�pon appropriation by the Board of Commissioners Yes❑ .No A budg <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: P 3 <br /> IL3 <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 b Manager El (Most other contracts$1,000 and above). Department Director approval only any <br /> $1,000). This contract has been e i wed and approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: —6 <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 />