R 2010-021 DEAPR - Jack Dougherty

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ORANGE COUNTY—CONTRACT CONTROL SHEET Routing Order: (1)Department, (2)IT, (3)Risk Management, (4)Financial Services, (5)Attorney,(6)Manager, (7)Clerk This Document shall accompany all contracts and shall be submitted for signature in the Routing Order specified above. If the Manager detennines 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: Jack Dougherty Party/Vendor Contact Person: Jack Dougherty Contact Phone:252 367-8969 Party/Vendor Address: 1508 W. Lake Drive City Greensboro State:NC Zip:27408 Department: Parks& Recreation Amount: 1890.00 Purpose: Specialized Guitar Instruction Budget Code(s): 630000 Vendor#59166 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New® Renewal ❑ Amendment ❑ Effective Date 01/14/2010 Approved by Board Yes❑No ® Agenda Date: Title of Contract: Services Agreeement 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: Date: 2 - 1 —/ 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: IT Dir Signature: Date: Risk Management Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; [ OR No Insurance Required ❑. Hold Contract pending receipt of Certificate of Insurance R. With incorporation of Insurance provisions as shown, this contract is approved by the Risk Manager: Risk Manager's Signature: Date: �v k?2c.d 2131ZOio Financial Services This Contract is conditioned upon appropriation by the Board of Commissioners Yes❑No❑. A budget amendment is necessary before approval Yes❑ No❑. If budget amendment is necessary,please attach to this form. This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Financial Services Director's Signature: 1,&�iYY,v Date: al?LtD County Attorney Approval by Board ❑ (Contracts over $25,000.00 or any BOCC consultant contract). Approval by Manager (All contracts $25,000.00 or less with the exception of BOCC consultants). This contract has been reviewed and approved by the Attorney as to legal form and sufficiency: Attorney's Signature Date: D County Manager This contract has been reviewed and is approved by the County Manager Y No[:]. This contract has been reviewed and is to be submitted for BOCC conside ation Yes❑No Manager's Signature: Date: L/y =Clerk he Board Submitted for Chair signature: Clerk's n ure: Date: Revised December 2009