HomeMy WebLinkAbout2012-075 HR - SafeSkills $1,690 C
,p,i 2 , o 5 ORANGE COUNTY—CONTRACT CONTROL SHEET y
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 Ye.
PartyNendor Name: SafeSkills PartyNendor Contact Person: Beth Siegler/Kathy Hopwood Contact Phone:919-383-7233 v"V�72 ��NK•
PartyNendor Address:P. O. Box 6164 City Durham State:NC Zip:27715 Department: }}f{ Amount: $1,690.00 Purpose:Training-
Budget Code(s): 10295020/720016 Vendor# (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No ContraiT-
Type: (Check one)New® Renewal❑ Amendment ❑ Effective Date 03/20/2012 Approved by Board Yes❑No P/ 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 ontent: l / )
lgw•ti wo toy : I •
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Department Director's Signature: . 1 Date: 3 ^arrael f
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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; [IOR No Insurance Required ❑. Hold
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: �ain11-- Date: 3 Z7 l 7�
C 's ,9 03/
/ :2 c.e.p4 EA- Financial Services,
This Contract is conditioned pon appropriation by the Board of Commissioners Yes❑No[og A budget amendment is necessary
before approval Yes❑ No[ . If budget amendment is necessary, please attach to this form. This instrument has been pre-audited in the
manner required by the Local Government Budget and Fiscal Control Act: I
Financial Services Director's Signature: �0"-v— .„4,•,...._____ Date: J Zi. l 7
County Attorney
Approval by Board ❑ (Contracts over $90,000.00 for goods or services, $250,000.00 for construction, or any BOCC consultant
contract). Approval by Manage I' (Allrgther contracts). This contract has been reviewed and approved by the Attorney as to legal
form and sufficiency: / n
liAttorney's Signature vr ;k Date: Z
County Manager
This contract has been reviewed and is approved by the Coun Manager YestfrNo❑.
This contract has been reviewed and is to be ,i�% �' , for :'AC -snsideration Yes❑NeO�
Manager's Signature: / / Date: 3 -c - / C�
g g
`..Clerk to the Boat
Approved by BOCC on the day of ,20 mitted,for Chair signature on the day of ,20 .
Clerk's Signature: .__� Date: !
Revised April 2010