HomeMy WebLinkAboutR 2013-200 Aging - Linda Textoris for Fit Feet Nurse ORANGE COUNTY—CONTRACT CONTROL SHEET
Routing Order: (l)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 ie not appropriate for Manager approval the Manager shall submit the contract for B{)CCapproval. Contracts for
B0CC approval must be submitted throuah, and complete,the routing process prior to agenda review. Contracts for legal review nbuold
be completed through the legal review process prior to being routed for signature.
Department
Party/VeodwrY4ume: Iildalextorjs Party/Vendor Contact Person: same Contact Phone:_____ 9az�/Veudu/Add�oo:Z5}Weaver
Dairy Road, #204 City Ch��J�8S NC Zip:27514 Department:Aging $�K��U Purpose:Fit Feet Nurse Budget
Cocle(s): 29430320-622000 Vendor#58380 (N/A if new vendor) Vendor is a BOCC consultant? Yes r_1 NoE Contract Type:
(Check one)New R Renewal Z Amendment F� Effective Date July 1,2013 Approved by Board YesFj NoEl Agenda Date:
Title of Contract: Wellness Instructor
I f'///» /` u Grant Agreement, pre-application has been approved oy the Board o/ Commissioners xeuLJmoLJ. u submitted for bid were
hido'K|'Ps received YemF_1NoM Bid/RFP number This contract has been reviewed and approved by the Department Director as to
technical content:
Department Director's Signature: Date:
IT Director
(Applicable only uohurdwmzvsoftvoru purchases or related services)This contract has been reviewed and approved hy the Information
Technology Director as to technical content and information technology specifications:
IT Director's Signature: Date:
Risk Manaaemen
Include the following coverages: R CGL; F� Auto; Fl WC; [_l PooO:omkn/ul; M Property; OR No Insurance Required FE^ Hold
Contract pending receipt ofCcrtifioatenfInsurance F]. With incorporation of Insurance provisions oy shown,this contract imapproved
6y the Risk Manager:
Risk Manager's Signature: Dute: /
� — - -- �
Financial Services
]'his Contract isconditioned Won appropriation hy the Board of Commissioners YeunNuEO & budget amendment iunecessary
hc|orc approval Y*xF� No[g. |y budget amendment is necessary, p|muoo attach to this 0nnu. This instrument has been pre-audited in the
nnaonerpcquiod by the Local Government Budget and Fiscal Control :
Piuuwxiul Services Director's Signature: J) A-- Date: IN13
County Attorney
Approval by Board El (Contracts $9008 or more for goods or services, $250,000.00 or more for construction, or any 8OCC
consultant contract). Approval by @8uougc,W (Most other contracts$1`000 and above). Department Director approval only Fl(Jodor
S|.00O). This contract has be revie and approved by the Attorney as to legal form and suffici
Attorney's Signature Date:
County Manage
'This contract has been reviewed and is approved by the County Manager YesFrNoD.
This contract has been reviewed undi for signature by the Chair YesMNoff7_
5 � ��
Manager's Signature: Dme:
Clerk to the Board
Approved by B0CC on the___day of 20 . Submitted for Chair signature oo the___day of 20____
Clerk's Signature: Date:
Revised March 2012