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i <br /> ORANGE COUNTY—CONTRACT CONTROL SHEET 10q <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: Barbara Chaiken Party/Vendor Contact Person: same Contact Phone: Party/Vendor Address: 2 Crestbury <br /> Ct City Durham State:NC Zip: 27713 Department: Aging-Wellness Amount: $700.00 Purpose: Dance Class Budget Code(s): <br /> 29430320-630000 Vendor#N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one) <br /> New® Renewal ❑ Amendment ❑ Effective Date 10/01/10 Approved by Board Yes❑No® Agenda Date: Title of <br /> Contract: Wellness Instructor <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. Date: Q=� C� <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; [�J'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: v <br /> 122 r d t o/o,Cz�v io <br /> Financial Services <br /> This Contract is conditioned upon appropriation by the Board of Commissioners Yes❑Nox. A budget amendment is necessary <br /> before approval Yes❑NoNn. 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: a"44, AtA.4 Date: <br /> County Attorney <br /> Approval by Board ❑ (Contracts over $90,000.00 for goods or services, $250,000.00 for construction, or any BOCC consultant <br /> contract). Approval by Manager All other contracts). This contract has been reviewed and approved by the Attorney as to legal <br /> form and sufficiency: <br /> Attorney's Signature -` 't ,zt Date: <br /> U <br /> County Manalzer <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 for BOCC conside ation Ye El❑ 912' <br /> Manager's Signature: Date: 13 (0 <br /> Clerk to the Board <br /> Approved by BOCC on the day of 920 Submitted for Chair signature on the day of 520 <br /> Clerk's Signature: Date: <br /> Revised April 2010 <br />