HomeMy WebLinkAbout2012-162 Aging & Nancy Alton for Trainer $6,0001 �Z 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
determines 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: Nancy Alton Party/Vendor Contact Person: same . Contact Phone: Party/Vendor Address: 3917 Marklyn Pl
City Hillsborough State: NC Zip: 27278 Department: Agiqg Aging Amount: $6,000..00 Purpose: trainer Budget Code(s): 10430120-630000 -
71085 Vendor # 58145 (N /A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ❑
Renewal ® Amendment ❑ Effective Date 07/01/2012 Approved by Board Yes❑ No® Agenda Date: Title of Contract:
If this is a Grant Agreement, pre - application has been approved by the Board of Commissioners Yes❑ No❑. If submitted for bid 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: y - /y /z
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 Director's Signature:
Date:
Risk Management
Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Require E�! Hold
Contract pending receipt of Certificate of Insurance El. With incorporation of Insurance provisions as shown, this contract is approved
by the Risk Manager:
Risk Manager's Signature: Date: 0-
kFC Le 6//5
Financial Services
This Contract is conditione on appropriation by the Board of Commissioners Yes❑NoN( A budget amendment is necessary
before approval Yes❑ NoIf budget amendment is necessary, please attach to this form. This instrument has been pre- audited in the
manner required by the Local Government Bud et and Fiscal Control Act: -29,
Financial Services Director's Signature: Date: vo �l
County Attorney
Approval by Board ❑ (Contracts $90,000.00 or more for goods or services, $250,000.00 or more for construction, or any BOCC
consultant contract). Approval by Manager QN (Most other contracts $1,000 and above). Department Director approval only ❑ (Under
$1,000). This contract has :;4z;:7 y the Attorney as to legal form and sufficiency:
Attorney's Signature Date: 2 /2.
County Manager
This contract has been reviewed and is approved by the County Manager YesE]"Po❑.
This contract has been reviewed and is for signature by the Chair Yes❑No[2-- %
Manager's Signature: Date:
Clerk to the Board
Approved by BOCC on the _ day of 20 . Submitted for Chair signature on the day of 20
Clerk's Signature:
Revised March 2012
Date: