HomeMy WebLinkAboutR 2014-280 Aging - Daniel Eubanks for acrylic classes 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: Daniel Eubanks Party/Vendor Contact Person: same Contact Phone: Party/Vendor Address:2300 Judah
Benjamin Court City Hillsborough State:NC Zip:27278 Department:Aging Amount: $5,200.00 Purpose: senior center classes
Budget Code(s): 10430120-629000 Vendor#62349 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract
Type: (Check one)New❑ Renewal® Amendment ❑ Effective Date 07/01/14 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: '9-13K
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 I surance Required . Hold
Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as sh ,�i0wf& t(�7a
by the Risk Manager: U UU
Risk Manager's Signature: vl�G"�►-tv �� Date: N I JUN 10 2014
Financial Services BY
This Contract is conditioned on appropriation by the Board of Commissioners Yes❑Nod A budget amendment is necessary
before approval Yes❑NoN. 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: (�
Financial Services Director's Signature: ua c'`'r" 0' )d.,,— Date:
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 anager (Most other contracts$1,000 and above). Department Director approval only❑ (Under
$1,000). This contract has been r vi wed proved by the Attorney as to legal form and sufficiency:
Attorney's Signature Date:
County Manager �
This contract has been reviewed and i ap ve y the County Manager Yes®E lo❑.
This contract has been reviewed is f ig at r7b,y e C es o❑.
Manager's Signature: Date: /
Clerk to the Board
Approved by BOCC on the_day of ,20 Submitted for Chair signature on the_day of 120 .
Clerk's Signature: Date:
Revised March 2012