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i <br /> ORANGE COUNTY-CONTRACT CONTROL SHEET (0 <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. ,^ ( n / �j <br /> Department To*t(PV au,& I <br /> Party/Vendor Name: Chapel Hill Carrboro City Schools Party/Vendor Contact Person: Sheldon Lanier Contact Phone: 919-967-8211 / <br /> x28247 Party/Vendor Address: 750 S.Merritt Mill Rd. City Chapej Hill State:NC Zip:27516 Department:Health Amount:$45,540 Y <br /> Purpose:Provide Summer K-Readiness program Budget Codes 10412020-681000-71453 Vendor#22226 (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes❑No® Contract Type:(Check one)New❑ Renewal® Amendment ❑ Effective Date 5/1/16 <br /> Approved by Board Yes❑No❑ Agenda Date: Title of Contract:CHCCS Kinder Jump Outside Agency 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❑Non Bid/RFP number This contract has been reviewed and approved by the Department Director as to <br /> technical content: <br /> JJ <br /> Department Director's Signature: Date: �P- <br /> 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 Require ❑. 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: t <br /> Risk Manager's Signature: ��1.�-� ti�`~"�-_ Date: <br /> Financial Services <br /> This Contract is conditioned upon appropriation by e Board of mmissioners Yes❑No❑. A budget amendment is necessary <br /> before approval Yes❑No❑. If budget amendm is ne ssary lease attach to this form. This instrument has been pre-audited in the <br /> manner required by the Local Government Budge d F. al o of Act: ff <br /> Financial Services Director's Signature: Date: b <br /> Ix County Attorney <br /> Approval by Board ❑ (Contracts $90,00 00 or more for goods or services, $250,000.00 or more for construction, or any BOCC <br /> consultant contract). Approval b Manager%K(Most other contracts$1,000 and above). Department Director approval only F] (Under <br /> $1,000). This contract has been v ed an proved by the Attorney as to legal form and sufficiency: <br /> Attorney's Signature Date: (0 1 J <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Yes❑Non. <br /> This contract has been reviewed an 's for si>aature by the Chair Yes❑No❑. <br /> Manager's Signature: Date: C</' <br /> Cler to the Board <br /> Approved by BOCC on the,day ,20 . Submitted for Chair signature on the_day of 20 <br /> Clerk's Signature: tl, ff <br /> g / Date: J l� <br /> i <br /> G <br /> Revised March 2012 <br />