HomeMy WebLinkAbout2012-260 S Mgr - Arc of Orange County Outside Agency $3,000 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: Arc of Orange County PartyNendor Contact Person: Robin Baker Contact Phone: 'arty/Vendor Address:
208 N. Columbia St. City Chapel Hill State:NC Zip:27514 Department:County Manager Amount. .3 000 P. •ose: Outside Agency
Funding Budget Code(s): 10495050 719023 Vendor#50706 (N/A if new vendor) Vendor is a B•CC co.. ltant? Yes❑No[E]
Contract Type: (Check one)New❑ Renewal ® Amendment ❑ Effective Date 7/1/2012 Appro :, - :oard Yes No❑
Agenda Date: 6/19/2012 Title of Contract: 2011-12 Outsi• A.enc Performance A. eement
If this is a Grant Agreement,pre-application has been app •ved by the Board of Commissioners Yes❑No❑. If submitted for bid were
bids/RFPs received Yes❑No❑ Bid/RFP num• r his contract has been reviewed and approved by the Department Director as to
technical content: I r_
Department Director's Signature.�`�'\ a()G _ Date: 7i 1 K7 `�
if ector
(Applicable only to hardware/software purchases or related se is contract has been reviewed and approved by the Information
Technology Director as to technical content and information technology specifications:
IT Director's Signature: Date:
isk Management
Include the following coverages: CGL; Ef Auto; WC; ❑ Professional; 2/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: lrf Risk Manager's Signature: 6(('"'"'t' ✓�► Date: t 194 -
Financial Services
This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No[E(. 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: N
Financial Services Director's Signature: /11 AA...-- Date: f 24(It.-
-
County Attorney
Approval by Board& (Contracts $90,0►`•Al0 or more for goods or services, $250,000.00 or more for construction, or any BOCC
consultant contract). Approval by Manag- .! (Most other contracts$1,000 and above). Department Director approval only❑ (Under
$1,000). This contract has b- review ai approved by the Attorney as to legal form and sufficiency:
Attorney's Signature ...A.-011, Date: 1(23112.
County Manager
This contract has been reviewed and is approved by the County Manager YesffrNo❑.
This contract has been reviewed and is for si.nature by the Chair Yes To❑.
Manager's Signature: Oa 1,44111 Date: 7 /i._-
W_
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 March 2012