HomeMy WebLinkAboutR 2014-185 Aging - Michael Patterson for movement class and personal training le
ORANGE COUNTY—CONTRACT CONTROL SHEET
Routing Order: (I)Department,(2)IT,(3)Risk Management,(4)Financial Services,(5)Attorney,(6)Manager,(7)Clerk
This Document shaII 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: Michael Patterson Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: 1605 Cliff
St City Durham State:NC Zip:27707 Department:Aging Amount: $960.00 Purpose:Movement Class and Personal Trainine Budget
Code(s):29430320-630000 Vendor#62289 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type:
(Check one)New® Renewal❑ Amendment ❑ Effective Date 04/04/14 Approved by Board Yes❑No® Agenda Date:
Title of Contract: Wellness 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 incorporation of Insurance provisions 4sho �cr e
by the Risk Manager: /?Risk Manager's Signature: / �" 9 `'�- Date: APR 1 5 2014
Financial Services
This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No(� A budge ame
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::', J
Financial Services Director's Signature: Date: 1 'ILI
51'7
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 onl (Under
$1,000). This contract has bee eview d approved by the Attorney as to legal form and sufficiency:
Attorney's Signature Date: 5 'l
VV
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: 1 f r` 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