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HomeMy WebLinkAbout2012-311 S Aging - Harrison Brooke Senior Center Bridge Class $4,000 Q1 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: Harrison Brooke Party/Vendor Contact Person: same Contact Phone: Party/Vendor Address: 5323 Oakbrook Drive City Durham State:NQ Zip:27713 Department: Aging Amount: $4,000.00 Purpose: senior center bridge class Budget Code(s): 10430120-629000 Vendor 4 58534 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑NoZ Contract Type: (Check one)New❑ Renewal Z Amendment ❑ Effective Date 09/01/2012 Approved by Board Yes❑NoZ Agenda Date: Title of Contract: Senior Center-Brooke If this is a Grant Agreement,pre-application has been approved by the Board of Commissioners Yes❑No❑ If submitted for bid were bids/RFPs received Yes❑No❑ Bid/RFP number This contract has been reviewed and approved by the Department Director as to technical content: Department Director's Signature: Qm" &4 al-I Date: f-g 14 0 IT 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 Management Include the following coverages: ❑ CGL; ❑ Auto; F-1 WC; ❑ Professional; ❑ Property; OR No Insurance Required 1� 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: Date: al L01 I z: Financial Services This Contract is conditioned_Oon appropriation by the Board of Commissioners YesE]Nom/ A budget amendment is necessary before approval Yes❑Nol M. If budget amendment is necessary,please attach to this form. This instrument has been pre-audited in the manner required by the Local Government Budge l and Fiscal Control Act: Financial Services Director's Signature: Date: County Attornev Approval by Board ❑ (Contracts $90,000.00 or more for goods or services, $250,000.00 or more for construction, or any BOCC consultant contract). Approval by Manager� (Most other contracts$1,000 and above). Department Director approval only❑ (Under $1,000). This contract has bee reviewed and approved by the Attorney as to legal form and sufficiency: Attorney's Signature Z*4wv� Date:pia County Manager This contract has been reviewed and is approved by the County Manager Yes]2140m. This contract has been reviewed and is for sl* ture by the 9hair YesF-lNog,.- Manager's Signature: Date: 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