HomeMy WebLinkAbout2012-234 S Mgr - A Helping Hand -
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: A Helping Hand PartyNendor Contact Person: Cathy Ahrendsen Contact Phone: (919)403-5555 Party/Vendor
Address: 1502 West NC Hwy. 54, Suite 405 City Durham State:NC Zip:27707 Department:Outside Agencies Amount: $1,600
Purpose: Outside Agency Budget Code(s): 10495050-720085 Vendor#800034 (N/A if new vendor) Vendor is a BOCC consultant?
Yes 0 No Contract Type: (Check one)New Z Renewal 0 Amendment 0 Effective Date 07/01/2012 Approved by Board Yes
Z No0 Agenda Date: 06/19/2012 Title of Contract: 2012-13 Outside Agency Performance Agreement
If this is a Grant Agreement,pre-application as b -n approved by the Board of Commissioners Yes0 No0. If submitted for bid were
bids/RFPs received Yes[]No0 Bis • Pp r This contract has been reviewed and approved by the Department Director as to
technical content:
Department Director's Signatur tan crac g Date: 7^7 •••• 2--
Direct r
(Applicable only to hardware/software purchases or related s•INIIrr is contract has been reviewed and approved by the Infolluation
Technology Director as to technical content and information technology specifications:
IT Director's Signature: Date:
Risk Mrtagement
Include the following coverages: NICGL; dAuto; WC; a Professional; El Property; 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: et0"4"--4.--• • Date: if PI/2.-
Financial Services
This Contract is conditionepon appropriation by the Board of Commissioners Yes0Nolil A budget amendment is necessary
before approval Yes0 Noll. 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: 4 Date: / 211 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 0 (All other contracts). This contract has been reviewed and approved by the Attorney as to legal
form and sufficiency:
Attorney's Signature
Date: 71E3(12__
County Manager
This contract has been reviewed and is approved by the County Manager Yes[2-No0.
deration contract has been reviewed and is to be submitted for BOCC con eration Yes0NoE.
Manager's Signature: ZIAiLq Date: 1 - 1 1 2-
Clerk to the Board
Approved by BOCC on the day _ ,2 . Submitted for Chair signa,41.1 11: da of ,20
Clerk's Signature: Date: 1 e
Revised April 2010