R 2010-015-019 Aging - wellness instructors

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ORANGE COUNTY-CONTRACT CONTROL SHEET L j L ` -^1 Routing Order: (1)Department, (2)IT,(3)Risk Management,(4)Financial Services,(5)Attorney,(6)Manager, (7)Cleric This Document shall accompany all contracts and shall be submitted for signature in the Routing Order specified above. If the Manager determines the contract is not appropriate for Manager approval the Manager shall submit the contract for BOCC approval. Contracts for BOCC approval must be submitted through,and complete,the routing process prior to agenda review. Contracts for legal review should be completed through the legal review process prior to being routed for signature. Department Party/Vendor Name: Alton, Landis, Merrick,Newman,Wilkelman. Party/Vendor Contact Person: Kathie Kearns. Contact Phone: 919- 968-2076. Party/Vendor Address: _. City State: Zip: ► nent:Aging ,Amount: $3,420 Purpose: Senior Center Instructors Budget Code(s): 104301 & 294303 Vendor# see attached agreements (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type: (Check one)New❑ Renewal® Amendment ❑ Effective Date 02/01/10. If this is a Grant Agreement, pre-application has been approved by the Board of Commissioners Yes No . If submitted forbid were bids/RFPs received Yes❑ No❑. Bid/RFP number This contract has been reviewed and approved by the Department Director as to technical content: Department Director's Signature: "4, v Vl Date: f C) IT Director (Applicable only to hardware/software purchases or related services)This contract has been reviewed and approved by the Information Technology Director as to technical content and information technology specifications: I ector's Signature: Date: Risk Management Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; ❑ OR No Insurance Required El. Hold contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as shown, this contract is approved y the Risk Manager: ,k Manager's Signature: Date: c'd Z/z/Aor-o axe,a(, C'4 Sk U Financial Services ,ontract is conditio Req upon appropriation by the Board of Commissioners Yes❑NOX. A budget amendment is necessary approval Yes❑No ca . If budget amendment is necessary,please attach to this form. This instrument has been pre-audited in the required by the LoGovernment Budget and Fiscal Control Act: 1 Services Director's Signature: dut,� Date: G� County Attorney v Board ❑ (Contracts over $25,000.00 or any BOCC consultant contract). Approval by Manager (All contracts r less with the exception of BOCC consultants). This contract has been reviewed and approved by the Attorney as to legal ciency: nature Date. County Manager een reviewed and is approved by the County Manager Yes o❑.❑No en reviewed and is to be s fitted for B C considera on Yes Date: v (Clerk to the Board 's❑No❑ Agenda Date: Date: