HomeMy WebLinkAboutR 2013-353 Finance - Voices Together Outside Agency $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: Voices Together Party/Vendor Contact Person: Yasmine White Contact Phone: Party/Vendor Address:
206 Old Forest Creek Dr. City Chapel Hill State:NC Zip: 27514 Department: Finance and Administrative Services Amount: $5,000
Purpose: Outside Agency Budget Code(s): 10495050-719066 Vendor#62051 (N/A if new vendor) Vendor is a BOCC consultant?
Yes ❑No® Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date July 1,2013 Approved by Board
Yes®No❑ Agenda Date: June 18,2013 Title of Contract: Outside Agency Performance Agreement
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: t�(,�"`O""" �• �/��' Date: u 27
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:
¢f
islc Mana ement J fu,� ��j /fsnc
Include the following coverages: ❑ CGL; V 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: ?'a 'r C,0 A-{-&A,* 7(¢fv'd f e ,Q Vt,p-� -r6 ♦ ) WC-4- P1
Risk Manager's Signature: �(�� Date:
Financial Services
This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No R"" 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 Act:
Financial Services Director's Signature: f✓ d• 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 13.v Manager (Most other contracts$1,000 and above). Department Director approval only ❑ (Under
$1,000). This contract has bee re iew approved by the Attorney as to legal form and sufficie cy:
Attorney's Signature Date: 13
County Manager
This contract has been reviewed and is approved by the County Manager Ye No❑.
This contract has been reviewed and is for signatu by the air Yes❑N
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