Orange County NC Website
Browse       Search
55g <br /> 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: Chapel Hill Human Rights Center Party/Vendor Contact Person: Asif Khan Contact Phone: 919-590-5980 <br /> Party/Vendor Address: PO Box 461 City Carrboro State:NC Zip:27510 Department:Finance&Admin. Services Amount: $1,000 <br /> Purpose:Performance Agreement Budget Code(s): 10495050-719059 Vendor#62069 (N/A if new vendor) Vendor is a BOCC <br /> consultant? Yes ❑No® Contract Type: (Check one)New❑ Renewal ® Amendment ❑ Effective Date 7/1/2014 Approved by <br /> 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: <br /> Department Director's Signature: �U 40— Date: itlIV <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 El. Hold <br /> Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as shown,this contract is approved <br /> by the Risk Manager: <br /> Risk Manager's Signature: (2 Date: <br /> Financial Services <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: I <br /> Financial Services Director's Signature: '✓ >�• �J•�,�,L Date: ,l IL l [J <br /> it h-1 <br /> County Attorney <br /> Approval by Board ❑ (Contracts $90,000. 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 re 'e and approved by the Attorney as to legal form and sufficie cy: <br /> Attorney's Signature Date: l <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Yes No❑. <br /> This contract has been reviewe ❑No❑. <br /> Manager's Signature: n au <br /> Date: 1 I <br /> Clerk tot a 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 />