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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: Chapel Hill Carrboro City Schools Party/Vendor Contact Person: Ruby Pittman Contact Phone:919-967-8211 <br /> x28205 Party/Vendor Address: 750 S.Merritt Mill Rd. City Chapel Hill State:NC Zip: 27516 Department:Health Amount: $465,300 <br /> Purpose:Fuinds for school nurses Budget Code(s): 10495020-631100 Vendor#22226 (N/A if new vendor) Vendor is a BOCC <br /> consultant? Yes❑No® Contract Type:(Check one)New❑ Renewal® Amendment ❑ Effective Date 7/1/15 Approved by <br /> Board Yes®No❑ Agenda Date:June 16,2015 Title of Contract:Chapel Hill Carrboro City Schools School Nursing;Services <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: Z, ` Date: <br /> I irector <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 has sh <br /> by the Risk Manager: D 0 <br /> Risk Manager's Signature: Date: l3' JUL 2 8 2015 <br /> UU L-1 <br /> Financial Services <br /> This Contract is conditioned upon appropriation by the Board of Commissioners Yes❑No❑. A b <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 Bud nd Fiscal Control Act: <br /> Financial Services Director's Signature: W-i Date: ZO /� <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 c�6tract). Approval by Manager M(Most other contracts$1,000 and above). Department Director approval only❑ (Under <br /> $1,000). This contract has e n vie d pproved by the Attorney as to legal form and sufficie cy: <br /> Attorney's Signature Date: <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 120 Submitted for Chair signature on the_day of ,20 <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />