HomeMy WebLinkAboutR 2014-221 Library - Stephen Somers for family program, Fizz Boom Read 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: Stephen Somers Party/Vendor Contact Person: Stephen Somers Contact Phone: Party/Vendor Address:
1162 Double Pond Lane City High Point State:NC Zip:27265 Department: Library Amount: 345 Purpose:Programming Budget
Code(s): 10500020-630000 Vendor# (N/AA if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type:
(Check one)New® Renewal ❑ Amendment ❑ Effective Date Approved by Board Yes❑No® Agenda Date:
Title of Contract:
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❑Noye er This contract as been reviewed and approved by the Department Director as to
technical content:
Department Director' Si na Date:
/IT it tor
(Applicable only to hardware/s 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 Z. Hold
Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as shown,this contract is approved
by the Risk Manager: ( FMAY Risk Manager's Signature: . Date:5ls - 5 2014
Financial Services
This Contract is conditioned upon appropriation by the Board of Commissioners Yes❑No®. A b t amendment is necessa
before approval Yes❑No®. If budget amendment is necessary, please attach to this form. This instrume
manner required by the Local Government Budget and Fiscal Control Act:Financial Services Director's Signature: gay,� 'A ' ;11A�, Date: 4 L lT'n
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 eviewe proved by the Attorney as to legal form and sufficiency:
Attorney's Signature Date: �1
County Manager
This contract has been reviewed and is approved by the County Manager Yes[:]No®.
This contract has been reviewed and is for signature by the Chair Yes❑No®.
Manager's Signature: w( /p( 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