HomeMy WebLinkAbout2012-033 Aging & Sandra Smith $1,000ORANGE COUNTY - CONTRACT CONTROL SHEET_.
Routing Order: T Department, IT, (3) Risk Management, Financial Services Attorney, Manager, 7 Clerk
,
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 B CC approval. Contracts for
B CC 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 rooted for signature,
Department
Party Vendor Marne: Sandra L Smith Party Vendor Contact Person: same Contact Phone: Party Vendor Address: 114 Cha hir
Drive City Hi11sborough State: NC Zip: 27278 Department.- Aging Amount: 1,000.00 Purpose: Sewing Class Instructor Budget
Code(s)- 10430120-629000 endor # 61120 (N/A if new v n} o Vendor is a BOCC consultant? Yes No o tract Type:
(Check ore) New ® Renewal ❑ Amendment ❑ Effective Date march 8, 2012 Approved by Board Yes[:] Igo ❑ Agenda Date:
Title of Contract: Senior Center Instructor
If this is a Grant Agreement, pre - application has been approved by the Board of Commissioners Yes❑ No ❑. If submitted for bid were
id I FPs received Yes❑ No❑ Bid I FP number This contract has been reviewed and approved by the Department Director as to
technical content:
DppP 41 tinb Director's Signature: . Date:
� ff
IT Director
(Applicable on ly to hardwarelsqfNwre purchases or related services) This contract has been reviewed and approved by the In formation
Technology Director as to technical content and information technology specifications:
IT Director's Signature.
Date:
Risk Haan ement
Include the following coverages: El C L; ❑ Auto; ❑ WC; El Professional; El Property; BOIL No Insurance Required ], T -Told
Contract pending receipt of Certificate of Insurance ❑. with incorporation of Insurance provisions as shown, this contract is approved
by the Risk Manager:
Risk Manager's Signature: Date: IS
3e
Financial Services
This Contract is conditions upon appropriation by the Board of Commissioners Yes ❑I o A budget amendment is necessary
before approval Yes❑ No . If budget a� endinent is necessary., please attach to this form. Thi instrument has been pre- audited in the
manner required y the oc Government Budget and Fiscal Control Act:
Financial Services Director's Signature:
Date:
Cpty Attorney
Approval by Board ❑ (Contracts over $90,000.00 for goods or services, $250,000.00 for construction, or any B CC consu tart
contract). Approval by Manager F7 (All other contracts). This contract has been reviewed and approved by the Attorney as to legal
f r ni and sufficiency:
Attorney's Signature Date:
County Manager w
This contract has been reviewed and is approved by the County Manager Y0-mon.
This contract has been reviewed and is to be s it c for 16C consideration Yes❑No
61
�:
Manager's Signature: ��. Date:
'Clerk to the Board
Approved by B CC on the day of
Clerk's Signature:
Revised April 2010
Submitted for Chair signature on the day of , 20
Date: