HomeMy WebLinkAboutR 2013-188 Health - Diana Montgomery Documentation and evaluation of the Fairview Community Garden Project $4,225 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: Diana Montgome Party/Vendor Contact Person: Diana Montgomery Contact Phone: 919-593-0831
Party/Vendor Address: 1830 Halls Mill Road City Efland State:NC Zip:27243 Department: Public Health Amount: $4,225 Purpose:
Documentation and evaluation of the Fariview Community Garden project Budget Code(s): 10412020-680060-71076 Vendor#61441
(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:
t
Department Director's Signature: Date: 1 3
(Applicable only to hardware/software purchases or related services)This contract has been reviewed and approve ormation
Technology Director as to technical content a
IT ' ctor's Signature: a e:
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: Vt�A"'�"� ✓-�"' Date: 41413
Financial Services
This Contract is conditioned pon appropriation by the Board of Commissioners Yes❑No[Y( A budget amendment is necessary
before approval Yes❑No�f.. 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:
� —Act: �_
Financial Services Director's Signature: (y��"�"�'�' / , Date: 191/13
County Attorney
Approval by Board ❑ (Contracts $90,000,09 or more for goods or services, $250,000.00 or more for construction, or any BOCC
consultant contract). Approva Manager (Most 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 sufficiency:
Attorney's Signature Date: let
County Manamer
This contract has been reviewed and is approved by th h)te ty Manager Yo❑.
This contract has been reviewed and is fo 7 tore hair Y es❑No Manager's Signature: Date:
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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
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