HomeMy WebLinkAbout2012-084 DEAPR - Andeliene Vienna Croce $ 1,200 poi,i-0 8
ORANGE COUNTY—CONTRACT CONTROL SHEET
Routing Order: (1)Department,(2)1T,(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
PartyNendor Name: Andeliene Vienna Croce Party/Vendor Contact Person: Andeliene Vienna Croce Contact Phone:856-520-2037
PartyNendor Address: 100 Crest Street Apt C City Carrboro State:NC Zip:27510 Department:DEAPR Amount:$1200.00 Purpose:
Ecology -arm.rncr.- rruc or Budget Code(s):630000 Vendor ii 61079 (N/A if new vendor) Vendor r� a BOCC consultant? Yes❑No
im Contract Type:(Check one)New® Renewal ❑ Amendment ❑ Effective Date June 18,2012 Approved by Board Yes❑No
® Agenda Date: Title of Contract:Ecology Camp Instructor
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 ontract has been reviewed and approved by the Department Director as to
technical content:
1 " Department Director's Signature: Date: 12 i ) 2
IT Director
(Applicable only to hardnvare/soJhr'are 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 Required Hold
Contract pending receipt of Certificate of Insurance 0. With incorporation of Insurance provisions as shown,this contract is approved
by the Risk Manager: 401 Risk Mana er's Signature: � 4--/�� )M7' Date: �'li'/1i
'e 'CC0373�/1.Z �..,/
Financial Services
This Contract is condition d on appropriation by the Board of Commissioners Yes❑No . A budget amendment is necessary
before approval Yes❑No If budget amendment is necessary,please attach to this form. 's instrument 1100 ltpre-audited in the
manner required by the Lo I Government Bud t nd Fiscal Control Act:
Financial Services Director's Signature: G(^.L„c.-- JJ1 Date: I °
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 pi(All other contracts). This contract has been reviewed and approved by the Attorney as
to legal form and sufficiency: -
Attorney's Signature �' ` Date: /S �°2
County Manager
This contract has been reviewed and is approved by the County Manager Y.esinNo❑.
This contract has been reviewed and is for s nature by the air Yes❑Noe�
Manager's Signature: Date: r,- Z---v
Clerk to the B ar
Approved by BOCC on the_day of ,20 . Submit f d f • Hair signature on tl —I ay of ,20
Clerk's Signature: Date:
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Revised November 2011