HomeMy WebLinkAboutR 2013-494 Avis Barnes for TRU Club Advisor $500 �i5- 4°ty
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: Avis Barnes Party/Vendor Contact Person: Avis Barnes Contact Phone:n/a Party/Vendor Address:3113 Genlee
Drive City Durham State:NC Zip:27704 Department:Health Amount:$500 Purpose: TRU Club Advisor Budget Code(s):
10412020-630000 Vendor#52313 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type:(Check one)
New® Renewal❑ Amendment ❑ Effective Date 9/1/13 Approved by Board Yeso No❑ Agenda Date: Title of
Contract: Tru Club Advisor AB
If this is a Grant Agreement,pre-application has been approved by the Board of Commissioners Yes No If submitted forbid
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: "— =I3
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 incorporation of Insurance provisions as shown, this contract is approved
by the Risk Manager: 44
Risk Manager's Signature: Date:
l
Financial Services
This Contract is cond' oned upon appropriation by the Board of Commissioners Yes�lo❑. 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 Budge dd Fiscal A
Financial Services Director's Signature: D
`- t 45119
ate:
EZ15
County Attorney
Approval by Board ❑ (Contracts over $25,000.00 or any BOCC consultant contract). Approval by Manager ❑ (All contracts
$25,000.00 or less with the exception of BOCC consultants). This contract h_as been reviewed and approved by the Attorney as to legal
form and sufficiency:
Attorney's Signature ` Date: 1 Z �•
County Manager
This contract has been reviewed and is approved by the County Manager Yes❑Nor-1.
This contract has been reviewed and is to be submitted for BOCC consideration Yes❑No❑.
Manager's Signature: Date-Y__�
Clerk to the Board
Submitted for Chair signature:
Clerk's Signature: Date:
Revised December 2009