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ORANGE COUNTY—CONTRACT CONTROL SHEET 10 <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: Charles House Assoc. Party/Vendor Contact Person: Paul Klever Contact Phone: 919-967-7570 Party/Vendor <br /> Address: 109 Hillcrest Ave. City Carrboro State:NC Zip: 27510 Department: Outside Agency Amount: $9,000 Purpose: <br /> Budget Code(s): 10495050 710029 Vendor#800031 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract <br /> Type: (Check one)New ❑ Renewal ® Amendment ❑ Effective Date July 1,2010 Approved by Board Yes®No❑ Agenda <br /> 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 by the Board of Commissioners Yes❑No❑. If submitted for bid were <br /> bids/RFPs received Yes❑No❑ Bid/RFP number L� his contract has been reviewed and approved by the Department Director as to <br /> technical content: <br /> Department Director's Signature: Date: t�— <br /> 1 'rector <br /> (Applicable only to hay dware/software purchases or related servic his cont ct has been reviewed and approved by the Information <br /> Technology Director as to technical content and information ology cifications: <br /> IT Director's Signature: Date: <br /> Risk Management <br /> Include the following coverages: D�CGL; Auto; F!� WC; []'Professional; ❑ Property; ❑ 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 Si nature: Date: 8 trz)tlo <br /> Financial Services <br /> This Contract is conditioned pon appropriation by the Board of Commissioners Yes❑Nog A budget amendment is necessary <br /> before approval Yes❑ No�f.. 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: I <br /> Financial Services Director's Signature: / � - Date: 1 <br /> g qav(,�vUl A <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 Man e ❑ (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:11 1 1c7 <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager YvEj No❑., <br /> This contract has been reviewed and is to be submitted for BOCC consideration YPsMNo❑. <br /> Manager's Signature: Date: (6 11 d <br /> C erk 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: Date: .l Z <br /> Revised April 2010 <br />