HomeMy WebLinkAbout2012-244 S Mgr - KidSCope - $75,000 eta-,_-_-_,?(-4.- 9
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: KidSCope PartyNendor Contact Person: Linda Foxworth Contact Phone:919-644-6590 Party/Vendor Address:
800 Eastowne Drive,Suite 105 City Hillsborough State:NC Zip:27278 Department:Outside Agency Amount:$75,000 Purpose:
Outside Agency Budget Code(s): 10495050-710015 Vendor#80060 (N/A if new vendor) Vendor is a BOCC consultant? Yes El No
® Contract Type:(Check one)New® Renewal❑ Amendment ❑ Effective Date 07/01/2012 Approved by Board Yes Non
Agenda Date:06/19/2012 Title of Contract:2012- . u utside ; gency Performance Agreement
If this is a Grant Agreement,pre-application has b - approv d by the Board of Commissioners Yes❑Non. If submitted for bid were
bids/RFPs received Yes❑No❑ Bid/RFP nu ,• T s contract has been reviewed and approved by the Department Director as to
technical content: A AIWA I II rilk
Department Director's Sign. re: *.' Date: I
I2-
�P or
(Applicable only to hardware/software purchases or related ervices)Thi contract has been reviewed and approved by the Information
Technology Director as to technical content and information to • -:' specifications:
IT Director's Signature: Date:
Risk Management
Include the following coverages: [/CGL; [Auto; WC; [Professional; ❑ Property; El OR No Insurance Required 0. 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: �""�""`^' 1D• Date: ��12� �"
Financial Services
This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No . A budget amendment is necessary
before approval Yes❑No[. 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: /11 / 1�� Date: 1/1 ZI'i'z
County Attorney
Approval by Board ❑ (Contracts over $90,000.00 for goods or services, $250,000.00 for construction, or any BOCC consultant
contract). Approval by Manager El (All other contracts). This contract has been reviewed and approved by the Attorney as to legal
form and sufficiency:
Attorney's Signature Date:
County Manager
This contract has been reviewed and is approved by the County Manager Yes R o❑.
This contract has been reviewed and is to be submitted for BOCC consideration Yes2i1o0.
Manager's Signature: Date: 7 '1 ' -/Z
Clerk to the Board l
Approved by BOCC on the day of - ,2' . bmitted for Chair si$ on the ay of ,20 .
Clerk's Signature: 1 /_. Date: 7 /r i Z
Revised April 2010