HomeMy WebLinkAboutR 2013-027 Health - James Wise For Chapel Hill Hight School TRU Club Advisor $500 -=:?0 i3-C e7
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: James Wise. Party/Vendor Contact Person: James Wise. Contact Phone: (919) 929 106. 270. Party/Vendor
Address: 2324 Woodbury Drive. City Hillsborough. State: NC Zip: 27278 Department: Health Amou t: $5 Purpose: Chapel Hill
High School TRU Club Advisor Budget Code(s): 10412020_630000 Vendor # 57567 (N/A if new e or) Vendor is a BOCC
consultant? Yes ❑No® Contract Type: (Check one)New ❑ Renewal ® Amendment ❑ Effective ate July 1,2012.
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:
c
Department Director's Signature: !, Date:
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; ❑ WC; ❑ Professional; ❑ Property; ❑ OR No Insurance Required 21. 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: �W"�"'^' CJ. Am— Date: I p/ 13
Financial Services
This Contract is conditioned on appropriation by the Board of Commissioners Yes❑Nos 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: ff��
Financial Services Director's Signature: �w A ✓/�— Date: 4444
County Attorney
Approval by Board ❑ (Contracts over $25,000.00 or any BOCC consultant contract). Approval by Manager Y (All contracts
$25,000.00 or less with the ex eption of BOCC consultants). This contract has been reviewed and approved by the Attorney as to legal
form and sufficiency:
Attorney's Signature Date: �3
County Manager �
This contract has been reviewed and is approved by the County Manager Ye%jE_='No❑
This contract has been reviewed and is to bmit e f B CC consideration Yes❑Nqj'
Manager's Signature: Date:
Clerk to the Board
Approved by Board Yes❑No❑ Agenda Date:
Clerk's Signature: Date: