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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: Boys&Girls Club of Eastern Piedmont Party/Vendor Contact Person: Marvwinne Sherwood Contact Phone: 919- <br /> 663-6159 Party/Vendor Address: PO Box 1788 City Pittsboro State:NC Zip: 27312 Department: Finance&Admin. Services <br /> Amount: $2,000 Purpose: Performance Agreement Budget Code(s): 10495050-719055 Vendor#62140 (N/A if new vendor) Vendor <br /> is a BOCC consultant? Yes ❑No® Contract Type: (Check one)New❑ Renewal ® Amendment <br /> ❑ Effective Date 7/1/2014 <br /> Approved by Board Yes®No❑ Agenda Date: 6/17/2014 Title of Contract: 2014-15 Outside Agency Performance 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: /y <br /> Department Director's Signature: ��G' (•� �' /� Date: `q <br /> 144/Y <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 R. Hold <br /> Contract pending receipt of Certificate of Insurance R. With incorporation of Insurance provisions as show mcnW q�prm <br /> by the Risk Manager: �I u uu <br /> Risk Manager's Signature: ( A� — ... Date: SEP 1 1 2014 <br /> Financial Services By <br /> This Contract is conditioned Oon appropriation by the Board of Commissioners Yes❑Nom/ A budgetc <br /> ❑ <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 pct: r <br /> Financial Services Director's Signature: jjaA �C�✓ /j4A<_ Date: I/ 1 sj)y <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 by a ager&(Most other contracts$1,000 and above). Department Director approval only ❑ (Under <br /> $1,000). This contract has been rev ew 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 ❑. <br /> This contract has been reviewed and is for signature by the Chair Yes❑No❑. <br /> Manager's Signature: Date: p !� <br /> Clerk to the Board <br /> Approved by BOCC on the_day of 120 Submitted for Chair signature on the_day of ,20 <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />