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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. Contacts 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: Evelyn Deloatch Party/Vendor Contact Person: Evelyn Deloatch Contact Phone: Party/Vendor <br /> Address 8315 Mckee Rd City Durham State:NC Zip:27703 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#52143 (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 ED <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 /> LI <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 Re uired 71. Hold <br /> Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as sho ikEci ja�ijne by the Risk Manager: lV'J' I5 Risk Manager's Signature: � Date: SEP 1 9t LS Financial Services BY This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No� A budget amen men i <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 Ac : <br /> Financial Services Director's Signature: ) �'�G�—l.�.i A I <br /> g Date: a I <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 a BOCC <br /> consultant contract). Approval by ager❑ (Most other contracts$1,000 and above). Department Director approval only (Under <br /> $1,000). This contract has been re i d and approved by the Attorney as to legal form and sufficicie cy: <br /> Attorney's Signature Date: L l' <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Yes o❑. <br /> This contract has been reviewed and is for signature by the Chair Yes❑No❑. <br /> Manager's Signature: Date: <br /> Cl to the Board <br /> Approved by BOCC on the_day of . S miffed for Chair signature on the day of ,20 <br /> Clerk's Signature: A Date: al AV <br /> Revised March 2012 <br />