HomeMy WebLinkAbout2012-213 S DSS - Dr Betty Rintoul Foster Care Assessments $34,500 A
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ORANGE 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 cump|em,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: Dr. Betty Rintoul Party/Vendor Contact Per on: Dr.Betty Rintoul Contact Phone: 919-602-2482 Party/Vendor
Address: 608 Bolin Creek Dr. City Carrboro State:NC Zip: 27510 Department: DSS Amount: not to exceed$34,500 Purpose: Foster
Care assesments Budget Code(s): Vendor# (N/A if new vendor) Vendor is a BOCC consultant? Yes D No
Contract Type: (Check one)New�7 Renewal �� Amendment �l Effective Date Approved Yo��1 lN"V�|
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Agenda Date: Title of Contract: Dr. Betty Rintoul
If this is a Grant Agreement, pre-application has been approved by the Board of Commissioners Yeo0Nu0. If submitted for bid were
bido/RFpx received YcxFlYJo0 Bid/&FPnumhor This contract has been reviewed and approved by the Department Director as to
technical content:
Department Director's Signature: Date: 6)' (l3 '/2--
IT Director
(Applicable only to h purchases or related services)This contrac has been reviewed and approved by the Information
T«ohno|ogyDiock/romtotechnicu|uootcrtund information technology specifications:
iT Director's Signature: Date:
yisk Ma9agement
Include the following coverages: EZCGL; Auto; gVc; le Professional; El Property; OR No Insurance Required D Hold
Contract pending receipt of Certificate of Insurance MI. With incorporation of Insurance provisions as shown, this contract is approved
by the Risk Manager:
� 4i1]�inkm@uumger`o8igoatoro: x,n�w'*~^ �� /�pm»—� Du�:
Financial Services
This Contrac is conditi upun appropriation by the Board of Commissioners Yeo0Y4 . A budget amendment is necessary
before approval YesLi Y4"■ . 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: [y J. Date: / iv /J 2�
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County Attorney
Approval by Board 0 $90,000.0 or more for goods services, $250,000.00 or more for construction, or any BOCC
consultant contract). Approval • K8unugo, er contracts$1,000 and above). Department Director approval only 0 (Under
$1.080). This contract has bee vic*o° a d d6y the AuocnoYaoto legal form and eu85 i cy:
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Attorney's Signature
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County Manager
This contract has been reviewed and is approved by the County Manager Yes0 No0.
This contract has been reviewed and i for i nat by hair Ycx0Nn0.
` �/ �/'/�,-- �0�mnmgor`xSiQomtunu: Dute:/^ / �^ � -�___'
Clerk to the Board
Approved by BOCC on the day of ,20 . Subminrdf,,Chui,aignutupron&oduyof ,20 .
Clerk's Signature: Date:
Revised March 2012