HomeMy WebLinkAboutR 2013-352 Finance - Marian Cheek Jackson Center Outside Agency 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: Marian Cheek Jackson Center Party/Vendor Contact Person: Hudson Vaughn Contact Phone:
Party/Vendor Address: 510 W. Rosemary St. City Chapel Hill State:NC Zip: 27516 Department: Finance and Administrative Services
Amount: $4,500 Purpose: Outside Agency Budget Code(s): 10495050-719065 Vendor#N/A (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: 2013-14 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: Q
Department Director's Signature: ' Date: p 27 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:
is Manageme`t
Include the following coverages: [FCGL; '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: A-14. *•e-e& {.o A.A. - QC ct.S A-LcX i4c'^4LI i alb%-r+-J
Ne-ecl (�� ess:•�.,Q nC-. we is b4-_l uLz lo%z4-Co►.n �c'E
Risk Manager's Signature: �� �V �„�.�— Date: 4 l3 } �`
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Financial Services ¢ roor 006
This Contract is conditioned pon appropriation by the Board of Commissioners Yes❑Nov A budget amendment is necessary
before approval Yes❑ No budget amendment is necessary,please attach to this form. This instrument has been pre-audited in the
manner required by the Local Government Budget nd Fiscal Control Act:
Financial Services Director's Signature: Date: �3
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 y ana r X(Most other contracts$1,000 and above). Department Director approval only ❑ (Under
$1,000). This contract has bee ev e d a oved by the Attorney as to legal form and sufficiency:
Attorney's Signature C Date: 6 3
County Manager
This contract has been reviewed and is ap ov by the Co my Manager Yes o❑.
This contract has been reviewed is f si ur the air s❑No❑.
Manager's Signature: Date:
Orr
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