HomeMy WebLinkAbout2012-078 S Aging - Joyce Gornto $500 01,00 ' 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: Joyce Gornto PartyNendor Contact Person: Contact Phone: PartyNendor Address: 3431 Pickett Rd
City Durham State:NC Zip: 27705 Department: Aging-CBS Amount: $500.00 Purpose: Chair Yoga Budget Code(s): 29430320-
630000 Vendor#61228 (N/A if new vendor) Vendor is a BOCC consultant? Yes 0 No0 Contract Type: (Check one)New Eg
Renewal 0 Amendment El Effective Date April 30,2012 Approved by Board Yes0 No Agenda Date: Title of
Contract:
If this is a Grant Agreement,pre-application has been approved by the Board of Commissioners Yes0 No0. If submitted for bid were
bids/RFPs received Yes0 No0 Bid/RFP number This contract has been reviewed and approved by the Depai twent Director as to
technical content:
Department Director's Signature: aatAe-e-ez J. 4,6,._ Date: 3-.2 9 Aed
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: 0 CGL; 0 Auto; 0 WC; 0 Professional; 0 Property; OR No Insurance Required re: Hold
Contract pending receipt of Certificate of Insurance Ei. With incorporation of Insurance provisions as shown, this contract is approved
by the Risk Manager:
Risk Manager's Signature: WM e--44-• dr if Date: 5 2J?'I 7--*
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Financial Services
This Contract is condition pon appropriation by the Board of Commissioners Yes:No . A budget amendment is necessary
before approval Yes0 No LX. If budget amendment is necessary,please attach to this form. s instrument has been pre-audited in the
manner required by the Local.Government Budget nd Fiscal Contr 1 Act:
Financial Services Director's Signature: a/-4,-4"--- , Date:
County Attorney
Approval by Board 0 (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*(Most other contracts$1,000 and above). Department Director approval only, (Under
$1,000). This contract has been reviewed and approved by the Attorney as to legal form and sufficiency:
-',
,. .1
Attorney's Signature ----77
Date:
74-43
County Manager
This contract has been reviewed and is approved by the County Manager Yes0 No0.
This contract has been reviewed and is for signature by the Chair Yes0Nora
Manager's Signature: Date:
-'
,,-
Citric-to the Board
Approved by BOCC on the day of ,2 . ' b tted for Chair signature on the day of ,20 .
7-■.......■
Clerk's Signature: 40 Date: i
Revised March 2012