HomeMy WebLinkAbout2012-237 S Mgr - Communities in Schools of Orange Co --"<-=. 7
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: Communities in Schools of Orange County PartyNendor Contact Person: Sheila D. Sholes-Ross Contact Phone:
919-967-6677 PartyNendor Address: 151 East Rosemary Street, Suite 207 City Chapel Hill State:NC Zip:27514 Department:
Outside Agency Amount: $45,000 Purpose: Outside Agency Budget Code(s): 10495050-710034 Vendor#26951 (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 appro •d by the Board of Commissioners Yes❑No❑. If submitted for bid were
bids/RFPs received Yes❑No❑ Bid/RFP number -is contract has been reviewed and approved by the Department Director as to
technical content:
40
Department Director's Signature: = t= ) Date: 3 —1 Z
IT Dire or
(Applicable only to hardware/software purchases or related services)Thi -s Itra, 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: VCGLAcl Auto; ►/ WC; Ig3 Professional; (Property; ❑ OR No Insurance Required ❑. Hold
Contract pending receipt of Certificate of Insurance 0. With incorporation of Insurance provisions as shown,this contract is approved
by the Risk Manager:
Risk Manager's Signature: e",..,. I , Date: 1 q( 2-
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 t: 'f , /
Financial Services Director's Signature: q Date: �" /Z//L
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 anag 1=1 (All other contracts). This contract has been reviewed and approved by the Attorney as to legal
form and sufficiency: n
Attorney's Signature U Date: .1I13 12
County Manager
This contract has been reviewed and is approved by the County Manager YesEallo❑.
This contract has been reviewed and is to be submitted for BOCC consideration YesBNo❑.
Manager's Signature: Date: 7 — (l0—I Z
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 April 2010