HomeMy WebLinkAbout2012-247 - Mgr - Orange Congregations in Mission $35,000 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
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: Orange Congregations in Mission Party/Vendor Contact Person: Kay Stagner Contact Phone:(919)732-6194
Party/Vendor Address: 300 Millstone Drive City Hillsborough State:NC Zip:27278 Department:Outside Agency Amount:$35,000
Purpose:Outside Agency Budget Code(s): 10495050-710031 Vendor#800010 (N/A if new vendor) Vendor is a BOCC consultant?
Yes❑No Contract Type:(Check one)New® Renewal❑ Amendment El Effective Date 07/01/2012 Approved by Board Yes
0 No❑ Agenda Date:06/19/2012 Title of Contr.ct:2012-13 Outside Agency Performance Agreement
If this is a Grant Agreement,pre-application h. bee• approved by the Board of Commissioners Yes❑No❑. If submitted for bid were
bids/RFPs received Yes❑No❑ Bid/RFP n#,•-r This contract has been reviewed and approved by the Department Director as to
technical content:
Awl 1411■
Department Director's Signatur AMA-e� ■ Date: "7.- S '-
NNW
IT Di AL
(Applicable only to hardware/software purchases or related services) ntract has been reviewed and approved by the Information
Technology Director as to technical content and information technology specifications:
IT Director's Signature: Date:
Risk M agement
Include the following coverages: [�CGL; Auto; WC; professional; ❑ Property; ❑ OR No Insurance Required U . Hold
Contract pending receipt of Certificate of Insurance �. With incorporation of Insurance provisions as shown,this contract is approved
by the Risk Manager: /'
Risk Manager's Signature: C A. 41.--./ Date: 7//40 a
Financial Services
This Contract is conditioned Aon appropriation by the Board of Commissioners Yes❑No[( A budget amendment is necessary
before approval Yes❑No f. 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 /,d Fiscal Control Act: 11411Z Financial Services Director's Signature: `� o ' v i_ Date:
County Attorney
Approval by Board El (Contracts over $90,000.00 for goods or services, $250,000.00 for construction, or any BOCC consultant
contract). Approval by Man..er X(All other contracts). This contract has been reviewed and approved by the Attorney as to legal
form and sufficiency:
Attorney's Signature _ W VA Date: 7 1311a.
1 I
County Manager
This contract has been reviewed and is approved by the County Manager YesJ - o❑.
This contract has been reviewed and is to be submitted for BOCC c,nsideration Yesi'No❑.
Manager's Signature: i ' 0 0 7 Date: "/ _l 6 Z
Jerk to the Board
Approved by BOCC on the_day of A, 0/i bmitted for Chair signature on e d of ,20 .
Clerk's Signature: > / ■ Date / /�°'
Revised April 2010