HomeMy WebLinkAbout2012-099 S Health - Person County for Bioterrorism Coordinator $36,000 �o/A - mM� .
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ORANGE COUNTY—CONTRACT CONTROL SHEET ��
Routing Order: (l)Doparm�cut.(2)IT,(3)Risk��anu8cmeru.(4)Financial Services,(5)'�uoruoy.(6)0�uuug (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: Person County PartyNendor Contact Person: Janet Clayton Contact Phone: 336 597 2204 Pu,tyNcndo,Add,coe:
355-A South Madison Blvd. Roxboro,NC City Roxboro State:nc Zip: 27573 Department: Health Amount: 36.000 Purpose:
Bioterrorism Coordinator Budget Code(s): 10414020 630000 Vendor#24Z45 /A if new vendor) Vendor is a BOCC consultant?
Yes o0 Contract Type: (Check one)New Fl Renewal Amendment 0 Effective Date 7/l/20l2 Approved by Board Yes
ENoZ Agenda Date: Title of Contract:
If this is a Grant Agreement, pre-application has been approved by the Board of Commissioners Yco0No0. If submitted for bid were
6ido/QF9s received`yeo[ly4o[l 8id/BFPoumber This contrac has been reviewed and approved by the Department Director as to
technical content:
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l�epartmuwnt|�ireuu/r,oSignature: «��e�-~_- Date: -, - _° — ~—`� c_~_-
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(Applicable only to6uruwure6oftvure purchases vr related xervicox)7bi0000truutbuoboeorovimvcdanduppnvvcdhyd`olnfonuxLioo
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; Fl WC; 0 Professional; [l Property; OR No Insurance Required R-..- Hold
Contract pending receipt of Certificate of Insurance LI. With incorporation of Insurance provisions as shown, this contrac is approved
by the Risk Manager:
Risk Manager's Signature:
~ /).Am __ W Date: 1 '74 ' /z.~~ ,<�^'��
u� = �� ~��../i '�J �x'' {��v«� .` � - /2�^~� /"i,y^r�'i^z`^k„,f - z+^~xe
- Financial Services _Zmm~rA PA'
This Contract is cnnddi appropriation by the Board [Commissioners Yeu0YoX� A budget amendment is necessary
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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:
Financial Services Director's Signature: W4/14 A /)4,..-� - Date: 1-1(24' 12'
County Attorney
Approval F $ more for goods or services, $250.800.00 or more for construction, or any
BOCC
consultant contract). Appro by (Most other $1,000 and above). Department Di rectorapp,ovu l only 0 (Under
$}.000). Thiouoo�uc/buo
evie ed d approved byd,nAuonoeyuoto \egu\toonuuduufb
, �
Attorney's Signature Date: Lt AD� �^�
County Manager
This contract has been reviewed and is approved by the County Manager YceErNoLJ.
This contract has been reviewed and is for si aturcbyt"cChair yox0lNo2.-
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Manager's Signature: Q� ~ ' �� Date: ° ~ | — >2-^~
Clerk to the Board
Approved by BOCC on the day of A1 I S 4mitted for Chair signature on the day of ,20 .
' - Date: —/ / �V
Clerk's Signature: / / � ' -`''r' _2
Revised March 2012