HomeMy WebLinkAboutR 2013-120 DEAPR - Caroline Johnston for Dance camp $2,000 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: Caroline Johnston Party/Vendor Contact Person: Caroline Johnston Contact Pho 19,-830-5177 PartylVendor
Address: 9055 Hwy 39 S City Henderson State:NC Zip: 27537 Department: DEAPR Amount: 00.00 rose:Dance Camp
Instruction Budget Code(s): 630000 Vendor#61758 (N/A if new vendor) Vendor is a BOX co es ❑No® Contract
Type: (Check one)New ❑ Renewal ❑ Amendment ❑ Effective Date June 17,2013 App y Board Yes❑No® Agenda
Date: Title of Contract: Dance Instruction
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: Date: .4/22
IT Director
(Applicable only to hardwarelsof are purchases or related services)This contract has been reviewed and approved by the Information
Technology Director as t tec cal content and information technology specifications:
IT Director's Signature: Date:
Risk Manasement �/
Include the following coverages: E] CGL; ❑ Auto; El WC; ❑ Professional; [I Property; El OR No Insurance Required I 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: L WUIJ 114, /'� Date: 2513
Financial Services
This Contract is conditioned on appropriation by the Board of Commissioners Yes❑Na . 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/J ct: I
Financial Services Director's Signature: CI /✓. J_ Date: Z 51
County Attorney
Approval by Board ❑ (Contracts ov r $90,000.00 for goods or services, $250,000.00 for construction, or any BOCC consultant
contract). Approval by Manager (AlI other contracts). This contract has been reviewed and approved by the Attorney as to legal
form and sufficiency:
Attorney's Signature Date: —
County Manaser
This contract has been reviewed and is approved by the Coun anager YSs0__bk6,.
This contract has been reviewed and is to be it C onsidera ion Yes❑
Manager's Signature: Date: 1❑�
Clerk to the Board
Approved by BOC on the_day of 20 Submitted for Chair signature on the_day of 20
Clerk's Signature: Date:
Revised April 2010