HomeMy WebLinkAbout2012-216 S Aging - CHICLE, Gillooly Zhao for Senior Center Classes $12,200 __
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ORANGE COUNTY—CONTRACT CONTROL SHEET
Routing Order: (1)Department,(2)I7,(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
deteiiuines 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: CHICLE, Gillooly,Zhao Party/Vendor Contact Person: see attached Contact Phone: Party/Vendor
Address: City State: Zip: Department:Aging Amount: $12,20080 Purpose: senior center classes Budget
Code(s): 104]0)20-020000 Vendor#43D40/5133U/58260 (N/A if new vendor) Vendor is a BOCC consultant? Yes [1]NoI
Contract Type:(Check one)New El Renewal[E] Amendment Fl Effective Date 07/0l/2O12 Approved by Board `yee0No00
Agenda Date: Title of Contract: Senior Center Instructor
If this is a Grant Agreement,pre-application has been approved by the Board of Commissioners `ycx0NuFl. If submitted for bid were
bids/RFPo received l/eu0Nn0 8id/&FPounuber This contract has been reviewed and approved by the Department Director as to
technical content:
Department Director's Signature: Date: G '.?1"-/2._'
IT Director
(Applicable only to 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; Fl Auto; D wC; D Professional; 0 Property; OR No Insurance Required D. Hold
Contract pending receipt of Certificate of Insurance LI. With incorporation of Insurance provisions as shown, this contract is approved
by the Risk Manager:
Risk Manugmr,o&i&nmture: `�[��~°^~^ A AA,. Date: t
Financial Services
This Contract is condition- upon appropriation by the Board of Commissioners You0Y4 . A budget amendment is necessary
before approval Yco0 NoL. 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:
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County Finmnck mlS*rvkcex8�irectnr`oBkgmm*urm: �� Doto: �/ "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 J (Most other contracts$1,000 and above). Department Director approval only El (Under
$).000). This contract h be i d and
Attorney's Signature U Date: yy x/����
- � .� ' � -
" County Manager
This contract has been reviewed and is approved by the County Manager Y~~ErNoFl.
This contract has been reviewed and is for signature by the 'ir l,ou�lY4u{��-
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0Wuuuger`u8ignmtpre: �� ' �� Da��� � / ~
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Clerk to the Board
Approved by BOCC on the day of . 20 . Submitted for Chair signature on the day of . 20 .
Clerk's Signature: Date:
Revised march 2012