HomeMy WebLinkAbout2012-245 S Mgr - Middle School After School Program $57,000 A
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
PartyNendor Name: Middle School After School Program(CIS) PartyNendor Contact Person: Sheila D. Sholes-Ross Contact Phone:
919-967-6677 PartyNendor Address: 151 East Rosemary Street,Suite 207,PO Box 9454 City Chapel Hill State:NC Zip:27514
Department:Outside Agency Amount:$57,000 Purpose:Outside Agency Budget Code(s): 10495050-710036 Vendor#50710 (N/A if
new vendor) Vendor is a BOCC consultant? Yes❑No Contract Type: (Check one)New® Renewal ❑ Amendment ❑
Effective Date 07/01/2012 Approved by Board Yes®No❑ Agenda Date:06/19/2012 Title of Contract:2012-13 Outside Agency
Performance Agreement
If this is a Grant Agreement,pre-application has been ap• oved by the Board of Commissioners Yes❑No❑. If submitted for bid were
bids/RFPs received Yes❑NoE Bid/RFP number This contract has been reviewed and approved by the Department Director as to
technical content:
A11-11 r
Department Director's Signature: � Date:7 — 3 —1 2
Dir: tor
(Applicable only to hardware/software purchases or related services) • cont t 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: [ CGL; R'Auto; WC; [✓Professional; ❑ Property; ❑ OR No Insurance Required O. 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: 644.44, i'' 2i2_ Date: "!n
[ (Z
Financial Services
This Contract is conditioned upon appropriation by the Board of Commissioners Yes❑No[( A budget amendment is necessary
before approval Yes❑ No Y. 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 Con of Act.
Financial Services Director's Signature: t"" , 1 Date: 1L !2--
"l
County Attorney
Approval by Board Yf (Contracts over $90,000.00 for goods or services, $250,000.00 for construction, or any BOCC consultant
contract). Approval by M. . er ❑ (All other contracts). This contract has been reviewed and approved by the Attorney as to legal
form and sufficiency:
li�
Attorney's Signature / Ali Date: 7 l'3 ID_
County Manager
This contract has been reviewed and is approved by the County Manager Yee:I-No❑.
This contract has been reviewed and is to be submitted for BOCC consideration Yes1o❑.
Manager's Signature: j% j I `Date: ? —/CP -/ ?'
Clerk toy le Board
Approved by BOCC on the day of -,21 iilF(.mitred for CPI gnature on _..y of ,20
Clerk's Signature: + Date:
Revised April 2010