HomeMy WebLinkAboutR 2014-251 Housing - Inter-faith Council for Social Service, Inc. for Comm. House Men's Transitional Housing Facility 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: Interfaith Council for Social Service(IFC) Party/Vendor Contact Person: Allan Rosen Contact Phone: 919-929-
6380,ext.27 Party/Vendor Address: 110 West Main Street City Carrboro State:NC Zip: 27510 Department:Housing Human Rights
and Community Development Amount: $500.000 Purpose: Community House Men's Transitional Housing Facility Budget Code(s):
Vendor# (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type: (Check one)New
Renewal❑ Amendment ❑ Effective Date May 15,2014 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❑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 ctor
(Applicable only to hardware/sof are purchases or related services)T ' contract has been reviewed and approved by the Information
Technology Director as to technical content and information technology specs ations:
IT Director's Signature: Date:
Risk Management
Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Ins u JA
Contract pending receipt of Certificate of Insurance El. With incorporation of Insurance provisions as shoA M s p�by the Risk Manager: t 2014
Risk Manager's Signature: s j (�"` Date:
Financial Services By
This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No� A budget amendment is necessary
before approval Yes❑NoaIf 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:
Financial Services Director's Signature: l A � Date: 5 Z'r I y
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). A r 1 by Manager((Most other contracts$1,000 and above). Department Director approval only E] (Under
pp
$1,000). This contract has e n revi e d approved by the Attorney as to legal form and sufficiency:
Attorney's Signature Date: JA14-
Count Manager
This contract has been reviewed and is approv y the.County Manager Yes o❑.
This contract has been reviewed s f si a re the C r Yes No❑.
d
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