HomeMy WebLinkAboutR 2013-184 Health - Orange County Cooperative Extension to Amend the original agreement �«- 1&4
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: Orange County Cooperative Extension Service Party/Vendor Contact Person: Carl Matyac Contact Phone:919-
24� Party/Vendor Address: 1241 Alabama Avenue City Durham State:NC Zip:27705 Department: Public Health Amount:
_� rpose: Amend the original a r� e� Budget Code(s): 10412020-680060-71076 Vendor#654128 (N/A if new vendor)
r is a BOCC consultant? Yes❑No® Contract Type:(Check one)New❑ Renewal ❑ Amendment ® Effective Date June
6,2013 Approved by Board Yes❑No❑ Agenda Date: Title of Contract: Amendment to Services Agreement Cooperative
Extension
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:
(Applicable only to hardware/software purchases or related services)This contract has been reviewed and approy
Technology Director a ion tec no ogy specifications:
irector's Signature: Date:
Risk Management
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: Q l l
Financial Services
This Contract is conditioned pon appropriation by the Board of Commissioners Yes❑No5l A budget amendment is necessary
before approval Yes❑Noly 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: J-1- /4� Date: L It Y II3
County Attorney
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 b=rewe app roved by the Attorney as to legal form and sufficie cy:
Attorney's Signature Date: �.
County Manager
This contract has been reviewed and is approved by the County Manager o❑.
This contract has been reviewed and is fUignature t Chair YesE]NoV. n
Manager's Signature: Date:'*_t Clerk 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