HomeMy WebLinkAbout2012-415 S Library & CHAKA for Programming $75 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: CHAKA Party/Vendor Contact Person: Marvin Axelrod Contact Phone: Party/Vendor Address: 116 Brook
Lane City Durham State:NC Zip:27712 Department:Library Amount; 75 Purpose:Programming Budget Code(s): 10500020
630000 Vendor#38440 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type:(Check one)New
Renewal❑ Amendment ❑ Effective Date Approved by Board Yes❑No® Agenda Date: Title of Contract:
If this is a Grant Agreement,pre-application has en approved by the Board of Commissioners Yes❑No®. If submitted for bid were
bids/RFPs received Yes❑No® Bid/RFP er This contract has been reviewed and approved by the Department Director as to
technical content:
Department Director's Sig re: Date:
irector
(Applicable only to hardware/so lare r chases 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 Manaaement
Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ 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: Y j
Financial Services
This Contract is conditioned upon 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 Bud a and Fiscal
' C7f Act:
ure:
Date:Financial Services Director's Si gnat
l L
_ —
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 eviewed and approved by the Attorney as to legal form and sufficiency:
Attorney's Signature Date:
County Manaaer
This contract has been reviewed and is approved by the County Manager Yesallo®.
This contract has been reviewed and is for signat bly the Chair Yes❑No®.
Manager's Signature: +J ' ' Date.
erk 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