HomeMy WebLinkAboutR 2014-455 Health - Cindy Evans to provide accounting specialist services to OCHD 1-4 -J455
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: Cindy Evans Party/Vendor Contact Person: Cindy Evans Contact Phone: Party/Vendor Address:264 Osee
Rd City Sparta State:NC Zip:28675 Department:Public Health Amount: $3,200.00 Purpose:Provider will assist OCHD by
providing Accounting Specialist services Budget Code(s): 10410020-630000 Vendor#NA (N/A if new vendor) Vendor is a BOCC
consultant? Yes❑No® Contract Type: (Check one)New® Renewal❑ Amendment ❑ Effective Date August 19,2014
Approved by Board Yes❑No❑ Agenda Date:August 19,2014-November 3,2014 Title of Contract: OCHD AR CEVANS
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:
r
Department Director's Signature: Date: Y
IT irector
(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 as shown,
by the Risk Manager: D
Risk Manager's Signature: �� l Date: B AUG 2 �O 2014
S 1 Z.1
Financial Services �-
This Contract is conditioned goon appropriation by the Board of Commissioners Yes❑Nov A budget B
before approval Yes❑NoLV. 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 A t: 1
Financial Services Director's Signature: (44lik JJ, /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 Manager 1214Most other contracts$1,000 and above). Department Director approval only❑(Under
$1,000). This contract has bee re 'ew approved by the Attorney as to legal form and sufficiency:
Attorney's Signature Date: � �---
County Manager
This contract has been reviewed and is approved by the County Manager Yes o❑.
This contract has been reviewed and is for 7' natur by the Chair Yes❑No❑.
g
er
Mana g 's Signature: /// Date:
Clerk to the Board
Approved by BOCC on the_day of ,20 mitte for Chair signature on the ay of ,20
Clerk's Signature: Date: L �-
Revised March 2012