HomeMy WebLinkAboutR 2014-432 Finance - Housing for New Hope - Outside Agency Performance Agreement QL_
ORANGE ONTRACTCONTROL SHEET
Routing Order: (|)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 imnot appropriate for Manager approval the Manager shall submit the contract for BOCCapproval. 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.
Departmen
PurtyyVoudnrNnmo: Housing for New Hope Party/Vendor Contact Person: }oi Stepney Contact Phone: 919-489-6282 Party/Vendor
Address: 18 West Colony PI., Suite 250 City Durham State:NC Zip:27705 Department: Amount:
Purpose: u
BOCC consultant? Yes F�NoZ Contract Type: (Check one)New E] Renewal E Amendment M Effective Date 7/1/2014
�
If this is u Grant Agreement, p,o'uppuccuionnuo been approved by the mmam of Comnu/oaiouexu xcoo moLT If submitted for bid were
� hidm/RFPo received YcsF_lNoR Bid/RFP number This contract has been reviewed and approved by the Department Director as to
technical content:
d?,Department Director's Signature: Date:
IT Director
(Applicable only to hardwarelsoftware 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: 0 CGL; M Auto; [_1 WC; 0 Professional; M Property; OR No Insurance Required Hold
Contract pending receipt of Certificate of Insurance 0. With incorporation of Insurance provisions as showt
by the Risk Manager: In7m
Risk Manager's Signature: Date: t 06 7AUG 18 2014
Financial Services
This Contract is conditioned ypon appropriation by the Board of Commissioners YesFlNold A budgwx
before approval YesM NoM. 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: Date:
County Attorney
Approval by Board M (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 91(Most other contracts$1,000 and above). Department Director approval only M (Under
$1,000). This contract has oved by the Attorney as to legal form and sufficiency:
Attorney's Signature U - V\, County Manage I,-, Date: �xg lq—_
This contract has been reviewed and is approved by the County Manager Yes&XNoEl.
This contract has been reviewed and is signature by the Chair YesFINoE].
Manager's Signature: 46 z Date:
Clerk to the Board
Approved by BOCC on the_day of 20 Submitte o hair signature on the day of 20_.
Clerk's Signature: Date:
Revised March 2012