HomeMy WebLinkAboutR 2013-135 DEAPR - US Tae Kwon Do Center for Tae Kwon Do Camp $1,000 -2013 - v3s
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: US Tae Kwon Do Center Party/Vendor Contact Person: Steve Kim Contact Phone: 919 730-3697 Party/Vendor
Address: 15201 Rose Garden Lane City Durham State:NC Zip: 27707 Department: DEAPR Amount: $1000 Purpose:Tae Kwon Do
Camp Budget Code(s): 630000 Vendor#61681 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type:
(Check one)New ® Renewal ❑ Amendment ❑ Effective Date June 10,2013 Approved by Board Yes❑No❑ Agenda Date:
Title of Contract:Tae Kwon Do Camp 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: 511113
IT Director
(Applicable onlyto har are/software purchases or related services)This contract has been reviewed and approved by the Information
Technology Direc r a to technical content and information technology specifications:
IT Director's Sign ur Date:
Risk Management
Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; ❑ OR No Insurance Required [N/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/� ►�� �� ✓✓�� Date:
Financial Services
This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No� A budget amendment is necessary
before approval Yes[]No[1.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: Date: � L 3
County Attorney
Approval by Board ❑ (Contracts o $90,000.00 for goods or services, $250,000.00 for construction, or any BOCC consultant
contract). Approval by Manager (All other contracts). This contract has been reviewed and approved by the Attorney as to legal
form and sufficiency:
Attorney's Signature Date:J
Count Mana er
This contract has been reviewed and is approved by the County M naggy Yes o❑
This contract has been reviewed and is to be submi or o si erati Yes❑N
Manager's Signature: Date:
Clerk to the Board
Approved by BO on the_day of ,20 . Submitted for Chair signature on the_day of ,20
Clerk's Signatu e: Date:
Revised April 2010