HomeMy WebLinkAboutR 2013-137 Finance - Alliance of AIDS Services for Outside Agencies $2,500 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 • Alliance of AIDS Services Party/Vendor Contact Person: James Law Contact Phone: (919)834-2437
Party/Ven r Addr S.Harrington Street,PO Box 12583 City Raleigh State:NC Zip:27602 Department:Outside Agencies
Amount 2 ose: Outside Agency Budget Code(s): 10495050-719022 Vendor#50705 (N/A if new vendor) Vendor is a
BOCC t? Yes❑No® Contract Type: (Check one)New® Renewal❑ Amendment ❑ Effective Date 07/01/2012
Approved by Board Yes®No❑ Agenda Date: 06/19/2012 Title of Contract:2012-13 Outside Agency Performance Agreement
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: h
Department Director's Signature: Y"-t. ,/J• A--' Date: Sj(,(,7
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; [trProfessional; 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: 516113
Financial Services
This Contract is conditioned on appropriation by the Board of Commissioners Yes❑Now A budget amendment is necessary
before approval Yes[:]No[yIf budget amendment is necessary,please attach to this form. This instrument has been pre-audited in the
manner required by the Local Government Budott and Fiscal Control Act:
Financial Services Director's Signature: l/l �'�""" / Date: G/13
County Attornev
Approval by Board ((Contracts over $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: ff 22
Attorney's Signature Date:-6f]31 rs
County Manager /A
This contract has been reviewed and is approved by the County Manager Yes o
This contract has been reviewed and is to be sub ed f BOC c nsj ion s
Manager's Signature: Date:
Cle o 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