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HomeMy WebLinkAboutR 2013-185 Health - Pascale Mittendorf Documentation & evaluation of the Fairview Community Garden Project $4,225 N5 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: Pascale Mittendorf Party/Vendor Contact Person: Pascale Mittendorf Contact Phone: -64 1117 Party/Vendor Address: 1 Winnawa Walk City Hillsborough State:NC Zip:27278 Department: Public Health Amou . $4 2 Purpose: Documentation and evaluationof the Fairview Community Garden project Budget Code(s): 10412020-6 - 1076 Vendor#61440 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type: (Check one)New® Renewal ❑ Amendment ❑ Effective Date June 1,2013 Approved by Board Yes❑No❑ Agenda Date: Title of Contract: Garden Evaluation Plan 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: hector (Applicable o n l y to h a r d w a r e/s o f t w a r e purchases or related services)This contract has been reviewed and approve t Technology Director as to technical content and informatio . IT Dir ignature: Date: Risk Management Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required d Hold Contract pending receipt of Certificate of Insurance E]. With incorporation of Insurance provisions as shown,this contract is approved by the Risk Manager: Risk Manager's Signature: ua,� A Date: d(3 61 Iq 118 Financial Services This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No r❑/. A budget amendment is necessary before approval Yes[]NoIf 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- _ J Financial Services Director's Signature: 0 44 /'"'' Date: G 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,4y Manager XMost other contracts$1,000 and above). Department Director approval only ❑ (Under $1,000). This contract has be r vie d approved by the Attorney as to legal form and sufficie cy: Attorney's Signature Date: ml t5 County Manager This contract has been reviewed and is appro d by the County Manager Yes No❑. This contract has been reviewed is or si a re by the Chair Yes❑No Manager's Signature: Date: 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