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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: Town of Chapel Hill Police Department Party/Vendor Contact Person: Tiffany. Snee Contact Phone: 919-968- <br /> 2760 Party/Vendor Address: 828 Martin Luther King Jr Blvd City Chapel Hill State:NC Zip:27514 Department:Orange County <br /> Emergency Services Amount: Purpose:MOA Naloxone Program Budget Code(s): Vendor#64 (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes❑No❑ Contract Type:(Check one)New❑ Renewal❑ Amendment ❑ Effective Date <br /> Approved by Board Yes❑No❑ Agenda Date: Title of Contract: <br /> If this is a Grant Agreement,pre-application has been approved by th oard of Commissioners Yes❑No❑. If submitted for bid were <br /> bids/RFPs received Yes❑No❑ Bid/RFP numb r This co ct 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 Required ❑. 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: Date: / s- <br /> Financial Services <br /> This Contract is conditioned upon 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 Bu et nd Fiscal Control Act: <br /> Financial Services Director's Signature: 6?1yT;;z) '-1-AP1Wg1M GFb Date: <br /> Countv 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 Manager❑ (Most other contracts$1,000 and above). Department Director approval only,V(Under <br /> $1,000). This contract has be r ewed and approved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: �s <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Yes to❑. <br /> This contract has been reviewed and is for signature by the Chair Yes❑No❑. <br /> Manager's Signature: Date: y <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 />