HomeMy WebLinkAbout2012-139 S DSS - Dispute Settlement Center $10,000 /
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i - 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
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BOCC approval mus be submitted through,and complete,the routing process prior to agenda review. Contracts for legal review shonld
be completed through the legal review process prior to being routed for signature.
Department
PortyNxodorNmor: Disute Settlement Center Party/Vendor Contact Person: Frances Henderson Contact Phone: 919-929-8800
Party/Vendor Address: 302 West Weaver St. City Carrboro State:NC Zip:27510 Department: Social Services Amount: $10,000
Purpose:To Amend Original Agreement to Include Staff Training/Curriculum Development Budget Code(s): Vendor#
A if new vendor) Vendor is a BOCC consultant? Yes EI NoZ Contract Type: (Check one)New El Renewal Amendment
Z Effective Date 7/1/g1 Approved by Board l,uo0No0 Agenda Date: Title of Contract: Amendment to Dispute
Settlement Center
If this is a Grant Agreement, pre-application has been approved by the Board of Commissioners YumE]No0. If submitted for bid were
hido/RFPoreceived l'oa0No0 Bid/RFP number This contract has been reviewed and approved by the Department Director as to
technical content:
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]�xpurtmantD^irmcror`uSignature: /��*^�—__ Date: ��/,�/v- e�-_
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IT Director
(Applicable only tc 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 Sigoature: Date:
Risk Management
Include the following coverages: 0 CGL; E] Auto; 0 wc; 0 Professional; 0 Property; OR No Insurance Required 0. Hold
Contract pending receipt of Certificate of Insurance O. With incorporation of Insurance provisions as shown,this contract is approved
by the Risk Manager:
Risk Manager's Signature:, Date:
Financial Services
This Contract is condition d Commissioners l/ex��l� & budget umeodozoo1ixnecessary
before approval l/ex�l .'lfb ''et'amendou`��i000uoao�9, please o�acbtothis form. This boo�um�thas been pre-uud�edbothe
mam�,c��dby the�u�GovernmentB and Fiscal Contrn1Act:
0� L� � /JA.-L_.---- � � / ��FiounxiuY8orpiccoDirectur`m8ignmtore: Date:
County Attorney
Approval by Board El (Contracts $90.800.00 or mor for goods or services, $250,000.00 or more for construction, or any BOCC
consultant contract). Approval b Manager ' (Most other contracts$1,000 and above). Department Director approval only 0 (Under
$1,000). This contract has been reviewed and approved by the Attorney as to legal form and sufficiency:
Attorney's Signature, Date:
County Manager
This contract has been reviewed and is approved by the County Manager YouErNo0.
This contract has been reviewed and is for signature b - air Yes00oZ.
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Manager's Signature: x /^ -'^' Date: '-
&- "�}erkto the D«ound
of /V/l Submitted Do�Cba�oi�ou�rn«"�Hi/� day 20
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Clerk's Signature:
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Revised March 2012