HomeMy WebLinkAbout2012-058 Aging & Celestine Bone $1,000r
ORANGE COUSTT C I TRACT C N TR. L SHEET #: �
Routing Order: 1 Department, 2 IT, Risk Management, Financial Services, Attorney, Manager, Clerk
This Document shall accompany all contracts and shall be submitted for signature ill 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 routed for signature.
Department
Part f Vendor Name: Celestine c.. - - Party/Vendor Contact Person: s Contact Phone: PartyNendor Address: 1 002 Statler
Drive City Durham State: NC Zip: 27703 Department: Aging Amount: $1,000.00 Purpose: barber service at Seymour Center
Budget Code (s): 10430120 - 629000 Vendor # N/A (N/A if new vendor) Vendor is a B CC consult n_t Yes ❑ - -N _ ntract
Type: (Check one) New Z Renewal [:1 Amendment ❑ Effective Date 03/09/12 Approved by Board Yes❑ NoE Agenda Date:
Title of Contract: Senior Center Instructor S
If this is a Grant Agreement, pre -- application has been approved by the Board of Commissioners Yes❑ No[]. If submitted for bid were
bids/R-FPs received Yes❑ N ❑ id RFP number This contract has been reviewed and approved by the Department Director as to
technical content:
Department Director's Signature: Date: 3'J' Z
IT Director
(Applicable only to hardivarelsoftware purchases or i- lai c i -vices) This contract has been reviewed and approved by the Information
Technology Director as to technical content and information tecbnology specifications:
IT Director's Signature.
Date:
Kish Management
Include the following coverages: [:1 GL; [:1 Auto; ❑ WC; ❑ Professional; ❑ Property; � I No Insurance Required ❑. Hold
Contract pending receipt of Certificate of I urance ❑. With incorporation of insurance provisions as shown, this contract is approved
by the Risk Manager:
Risk Manager's Signature: 40-M6 Llt' Date: _ 0''Ttz--.
Financial Services
This Contract is condition up n appropriation by the Board of Commissioners Yes❑No . A budget amendment is necessary
before approval Yes❑ Na GIf budget amendment is accessary, please attach to this form. This instrument has been pre - audited ire the
manner required b the Lora overnment Budget and Fiscal Control Act:
Financial Services Director's Signature: 6(L4n_ CAJ Ao Date: 31 Irz,_
County Attorney
Approval by Board El (Contracts over $90,000.00 for goods or services, $250,000.00 for construction, or any B CC consultant
contract). Approval by Manager All dither contracts). This contract has been reviewed and approved by the Attorney as to legal
form and sufficiency:
Attorney's Signature Date:
County Manner,
This contract has been reviewed and is approved by the Counter Manager Yes N❑.
This contract has been reviewed and is to be submitted for BOCC consideration Yes ❑No [2.
F
1
Manager's is Signature: }# Date-
Clerk to the o id
Approved by BOCC on the day of 1,20 S b itted for Chair signature o the day of _ - - - - -_ � 20
3fClerk's Signature: Date:
V I '
Reprised April 2010