HomeMy WebLinkAbout2012-380 S Mgr - The Arc of Orange County $4,000 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
Party/Vendor Name: The Arc of Orange County Party/Vendor Contact Person: Robin Baker Contact Phone:919-942-5119
Party/Vendor Address:208 N.Columbia Street City Chapel Hill State:NC Zip:27514 Department:Outside Agency Amount:$4,000
Purpose:Outside Agency Budget Code(s): 10495050-719023 Vendor#50706 (N/A if new vendor) Vendor is a BOCC consultant?
Yes E]NoN Contract Type:(Check one)New Z Renewal❑ Amendment ❑ Effective Date 07/01/2012 Approved by Board Yes
Z No❑ Agenda Date:06/19/2012 Title of Contract:2012-13 Outside Agency Performance Agreement
If this is a Grant Agreement,pre-application has bee proves, y the Board of Commissioners Yes[]No[:]. If submitted for bid were
bids/RFPs received YesE]NoE] Bid/RFP nu7by,/ hi'contract has been reviewed and approved by the Department Director as to
technical content:
Department Director's Signature:7 aJVf_,1_ Datc�/, O
U I
IT ire
TT or
(Applicable only to hardware/software purchases Wrelat Ldse ces)ire
sc mract has been reviewed and approved by the Information
Technology Director as to technical content and information technology specifications:
IT Director's Signature: Date:
Risk MAnaizement
Include the following coverages: CGL; Auto WC; 9Professional; ❑ Property; ❑ OR No Insurance Required ❑. 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:
Financial Services
This Contract is conditioned on appropriation by the Board of Commissioners Yes❑Nolg/ A budget amendment is necessary
before approval Yes❑NoM.-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: ekm-,� J. Date: I IDJ a
County Attorney
Approval by Board r (Contracts over $90,000.00 for goods or services, $250,000.00 for construction, or any BOCC consultant
contract). Approval by Mana Y ❑ (All other contracts). This contract has been reviewed and approved by the Attorney as to legal
form and sufficiency:
Attorney's Signature Date: �D I 1-t )z-
County Manaize
This contract has been reviewed and is approved by the County Manager Y Non.
This contract has been reviewed and is to be sub ration Yes 0
Manager's Signature: Date:
Afll_e�rk 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