HomeMy WebLinkAboutR 2013-280 Aging Town of Carrboro for Program Support - $5,000 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: Town of Carrboro Party/Vendor Contact Person: Holl Hollan_ Contact Party/Vendor Address:
301 W.Main St City Carrboro State:NC Zip:27510 Department:Aging Amo : $5 0 urpose: Program Support Budget
Code(s): 10430105-449001-71086 Vendor#595 (N/A if new vendor) Vend i CC consultant? Yes❑No® Contract Type:
(Check one)New❑ Renewal ® Amendment ❑ Effective Date JuIY 1,20 pproved by Board Yes❑No❑ Agenda Date:
Title of Contract:Agreement-Orange Co.Dept. of Aging-Senior Lunch Program
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: T-If-/3
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 Manaeement
Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required El. 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: / Iw�C / � �1 ��� Date:
�. ~�1zz113
Financial Services
This Contract is conditioned u on appropriation by the Board of Commissioners Yes❑No❑. A budget amendment is necessary
before approval Yes❑ No Y. If budget amendment is necessary,please attach to this form. This instrument has been pre-audited in the
manner required by the Local Government Bud and Fiscal Control Act:
Financial Services Director's Signature: 0CWR -#9 ilf&�A Date:el 1� I
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 revie and approved by the Attorney as to legal form and suffi 'ency:
Attorney's Signature /`' ` Date-
County Z7J �3
County Manager
This contract has been reviewed and is approved by the County Manager YeANo❑.
This contract has been reviewed and is for!nature by the C 'r Yes❑ `
NoLo
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