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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: Freedom House Recovery Center Party/Vendor Contact Person: Trish Hussey Contact Phone: 919-942-2803 <br /> Party/Vendor Address: 104 New Stateside Dr. City Chapel Hill State:NC Zip: 27514 Department: Outside Agency Amount: $24,000 <br /> Purpose: Budget Code(s): 10495050 710037 Vendor#800030 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ <br /> No® Contract Type: (Check one)New❑ Renewal ® Amendment ❑ Effective Date July 1,2010 Approved by Board Yes®No <br /> ❑ Agenda Date: June 15,2010 Title of Contract: 2010-11 Outside Agency Performance Agreement <br /> If this is a Grant Agreement, pre-application has been approved b the Board of Commissioners Yes[]No❑. If submitted for bid were <br /> bids/RFPs received Yes❑No❑ Bid/RFP number i ntract has been reviewed and approved by the Department Director as to <br /> technical content: <br /> �- <br /> Department Director's Signature: C Date: �--� 0 <br /> irector <br /> (Applicable only to hardware/software purc .ases or related services)This contra s 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; R WC; [ Professional; ❑ Property; ❑ OR No Insurance Required El. 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:4 7 — <br /> 6 c d 11311v <br /> Financial Services <br /> This Contract is condition d pon 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 Bu et a�dFiscal Control Act:Financial Services Director's Signature: Date: 6 <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 agpr ❑ (All other contracts). This contract has been reviewed and approved by the Attorney as to legal <br /> form and sufficiency: <br /> Attorney's Signature Date: a 3 Zai� <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Y No <br /> This contract has been reviewed and is to be submitted for BO C consi ration 5,`A�NoEl <br /> Manager's Signature: Date: ` r <br /> Clerk to the Board <br /> Approved by BOCC on the day of ,20 Submitted for Chair signature on the day of ,20 <br /> Clerk's Signature: s Date: r ZS <br /> Revised April 2010 <br />