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ORANGE COUNTY—CONTRACT CONTROL SHEET S(.NO• 2-1 <br /> Routing Order: (1) Department, (2) IT, (3) Risk Management, (4)Financial Services, (5)Attorney, (6) Manager, (7)Clerl< <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: AccessCare. Party/Vendor Contact Person: Anita Hill. Contact Phone: 919-966-5941. Party/Vendor Address: PO <br /> 3000 Ariel Center Parkway Suite 101. City Morrisville. State: NC Zip: 27560 Department: Health Amount: Purpose: Provider <br /> Network Support Budget Code(s): 141402063000 Vendor#N/A (N/A if new vendor) Vendor is a BOCC consultant`? Yes ❑ No <br /> Contract Type: (Check one)New® Renewal ❑ Amendment ❑ Effective Date 12/1/2010. <br /> If this is a Grant Agreement, pre-application has been approved by the Board of Commissioners Yes No If submitted for bid <br /> were bids/RFPs received Yes❑ No❑. Bid/RFP number This contract has been reviewed and approved by the Department <br /> Director as to 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 Mana ement <br /> Include the following coverages: ❑ CGL.; ❑ Auto; ❑ WC; Professional; ❑ Property; ❑ OR No Insurance Required old <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: (,(/1N1 Date: / • �G /d <br /> Financial Services <br /> This Contract is condition d upon appropriation by the Board of Commissioners Yes❑No ]. A budget amendment is necessary <br /> before approval Yes❑Not. 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: <br /> Financial Services Director's Signature: <br /> ► A,,r-> Date: <br /> County Attorney <br /> Approval by Board ❑ (Contr cts over $25,000.00 or any BOCC consultant contract). Approval by Manager ❑ (All contracts <br /> $25,000.00 or less with the ex ep 'on of CC consultants). This contract has been reviewed and approved by the Attorney as to legal <br /> form and sufficiency: <br /> Attorney's Signature Date: l <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Ye No❑. <br /> This contract has been reviewed and is to be submitted fo•BOC considera on Yes❑NaO� <br /> Manager's Signature: Date: <br /> r rk to the Board <br /> Approved by Board Yes❑No genda Date: "� l <br /> ' Signature: Date: *� <br /> Clerk's S g <br />