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HomeMy WebLinkAboutR 2013-498 Aging - Ruth W Merrick for Instructor $4,500 ' 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: Ruth W Merrick Party/Vendor Contact Person: Contact Phone: Party/Vendor Address:215 S Hillsborough Ave City Hillsborough State:NC Zip:27278 Department:Aging Amount:$4,500.00 Purpose: instructor Budget Code(s): 10430120-629000 Vendor#58822 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type: (Check one)New❑ Renewal® Amendment ❑ Effective Date 12/01/13 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 I urance ❑. With incorporation of Insurance provisions as shown, this contract is approved by the Risk Manager: ,-�.p ,�� %t 16.r11t k__ Risk Manager's Signature: Date: Z i Financial Services This Contract is condit' ned upon 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 Bud et and Fiscal Con of Act* Financial Services Director's Sign t.. Date: 14 1 II 1.3 tz15 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 (Most other contracts$1,000 and above). Department Director approval only❑(Under $1,000). This contract has bee r iew id approved by the Attorney as to legal form and sufficien y: Attorney's Signature Date: County Manaser This contract has been reviewed and is a ov by the Coun Ma ger Yes 4o❑. This contract has been reviewe is s' n ure the air s❑No❑. G 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