HomeMy WebLinkAbout2012-243 S Mgr - Joint Orange Chatham Community $20,000 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
PartyNendor Name: Joint Orange Chatham Community Action(JOCCA) PartyNendor Contact Person: Sandra R.Morgan Contact
Phone:919-542-4781 PartyNendor Address:35 Chatham Street West,PO Box 27 City Pttsboro State:NC Zip:27312 Department:
Outside Agency Amount: $20,000 Purpose:Outside Agency Budget Code(s): 10495050-710006 Vendor#800008 (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-applicati. be: approved by the Board of Commissioners Yes❑No❑. If submitted for bid were
bids/RFPs received Yes[1]No❑ Bid • "' ,be. This contract has been reviewed and approved by the Department Director as to
technical content:
Department Director's . gnature: -�1V' _, Date: 1
`_, _g Director
(Applicable only to hardware/software 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 M agement
Include the following coverages: [�CGL; Auto; WC; professional; El Property; ❑ OR No Insurance Required 1=1. Hold
Contract pending receipt of Certificate of Insurance QC With incorporation of Insurance provisions as shown,this contract is approved
by the Risk Manager: nn// n,
Risk Manager's Signature: l/l ,�. /y'^4.--• Date:
Financial Services
This Contract is conditioned on appropriation by the Board of Commissioners YespNolle 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: l/1,a .A..l t/ A /d""^ Date: 71141 2'
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 ❑ (All other contracts). This contract has been reviewed and approved by the Attorney as to legal
form and sufficiency:
�1 O
Attorney's Signature Date:
la-
County
Manager
This contract has been reviewed and is approved by the County Manager YesEllgo❑.
This contract has been reviewed and is to be submitted for BOCC consideration Yes❑No❑.
Manager's Signature: 716-tth Date: 7 — /b
Clerk to the Board /
Approved by BOCC on the day of 20 . Submitted for Chair sig 4l . .n the day f ,20 .
Clerk's Signature: Date: 7 l / Z
Revised April 2010