Orange County NC Website
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: Nicole Kushner, DVM (Veterianarian). Party/Vendor Contact Person: Nicole Kushner. Contact Phone: 919- <br /> 5938428. Party/Vendor Address: 120 Sierra Drive. City Chapel Hill. State:NC Zip: 27514 Department: Animal Services Amount: not <br /> to exceed $25,000 ($40/hr) Purpose: Perform spay/neuter surgeries Budget Code(s): 10215020 629010 Vendor # tbd (N/A if new <br /> vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective <br /> Date 11/1/2009. <br /> If this is a Grant Agreement, pre-application has been approved by the Board of Commissioners Yes No If submitted forbid <br /> were bids/RFPs received Yes® No❑. Bid/RFP number 51516This contract has been reviewed and approved by the Department <br /> Director as to technical content: <br /> Department Director's Signature: /� • O 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 El. Hold <br /> Contract pending receipt of Certificate of Insurance F. With incorporation of Insurance provisions as shown,this contract is approved <br /> by the Risk Manager: <br /> Risk Manager's Signature: Date: <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 Budget and Fiscal Control Act: <br /> Financial Services Director's Signature: Date: 1 <br /> County Attorney <br /> Approval by Board ❑ (Contracts over $25,000.00 or any BOCC consultant contract). Approval by Manager ❑ (All contracts <br /> $25,000.00 or less with the ption of BOCC consultants). This contract has been reviewed and approved by the Attorney as to legal <br /> form and sufficiency: <br /> Attorney's Signature Date: I l 23 8 <br /> County Mana er <br /> This contract has been reviewed and is approved by the County Manager Ye No❑. <br /> This contract has been reviewed and is to b su mitted or BOCC consid rati Yes❑No❑. <br /> Manager's Signature: Date: L <br /> VW Clerk to the Board <br /> Approved by Board Yes o❑ Age da Date: <br /> Clerk's Signature: Date: <br />