HomeMy WebLinkAboutR 2013-260 DSS - Assistance Travel and Transport to provide transportation Services to clients identified by the county $35,000 9, 013- 40
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: Assistance Travel and Transport Party/Vendor Contact Person: Kenneth M. Williams, CEO Contact Phone: 919-
489-5050 Paty/Vendor Address: 3710 University Drive Suite 240 City Durham State:NC Zip:27707 Department: DSS Amount:
$35,000 Purpose: Provide transportation services to clients identified by the County Budget Code(s): 10403020-633000 Vendor#58559
(N/A ifaiev�vendor) Vendor is a BOCC consultant? Yes❑No❑ Contract Type: (Check one)New❑ Renewal❑ Amendment
1 ffective Date 07/01/14 Approved by Board Yes❑No❑ Agenda Date: Title of Contract:
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 Signatu Date: G_H ^f 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:
isk Ma a ement
Include the following coverages: CGL; Auto; FT WC; V 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: � Date: t 7
Financial Services
This Contract is conditioned on appropriation by the Board of Commissioners Yes No A budget amendment is necessary
before approval Yes❑ No�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 t: !
Financial Services Director's Signature: �"�-��' / Date: ! ��
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 X(Most other contracts$1,000 and above). Department Director approval only ❑ (Under
$1,000). This contract has bWiewe d appr oved by the Attorney as to legal form and sufficiency:
Attorney's Signature Date: ?� 3
County Manag
This contract has been reviewed and is approved by the Coun Manager Y El.This contract has been reviewed and is for sig e e 7esoNo��
Man ager'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