HomeMy WebLinkAboutR 2013-448 Aging - Jerry Passmore for In Praise of Age Editing $7,000 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 pr iox to being routed for signature.
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Department
Party/Vendor Name: Jerry Passmore Party/Vendor Contact Person: Contac Phone: Party/Vendor Address:P.O.Box
7870 City Ocean Isle Beach State:NC Zip:28469 Department: Aging Amount: Purpose: In Praise of Age editing Budget
Code(s): 10430020-630110 Vendor#NA (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check-
one)New® Renewal ❑ Amendment ❑ Effective Date 11/01/13 Approved by Board Yes[]No❑ Agenda Date: Title
of Contract: Senior Center Instructor
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:
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 Management
Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required ❑. Hold
Contract pending receipt of Certificate of Insurance ❑. With ingorporation of Insurance provisions as shown,this contract is approved
by the Risk Manager: �G 4% t, c-v j.�.g�w.,,,.f1
Risk Manager's Signature: a Date: 1Cf
Financial Services
This Contract is conditioned on appropriation by the Board of Commissioners Yes❑NoQ/ 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: I
Financial Services Director's Signature: "�� � � Date:
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County Attorney
Approval by Board ❑ (Contracts $90,000 0 or more for goods or services, $250,000.00 or more for construction, or any BOCC
consultant contract). Approv 1 by Manager W (Most other contracts$1,000 and above). Department Director approval only ❑(Under
$I,000). This contract has be vie d approved by the Attorney as to legal form and suffici ncy:
Attorney's Signature Date:
County Manager
This contract has been reviewed and is ap oved by the County Manager Yes[ o/❑.
This contract has been reviewed a s f si ture y the C r Y s❑No❑.
v
Manager's Signature: Date: ",
Clerk to the Board
Approved by BOCC on the_day of 120 Submitted for Chair signature on the_day of 20
Clerk's Signature: Date:
Revised March 2012