HomeMy WebLinkAboutR 2014-438 Finance - Orange County Disability Awareness Council - Outside Agency Performance Agreement ,=,Qol�4f - .J�
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: Orange County Disability Awareness Council Party/Vendor Contact Person: Tim Miles Contact Phone:
Party/Vendor Address: 503 W. Franklin St. City Chanel Hill State:NC Zip: 27516 Department: Finance&Admin. Services Amount:
$4,000 Purpose: Performance Agreement Budget Code(s): 10495050-710032 Vendor#800037 (N/A if new vendor) Vendor is a
BOCC consultant? Yes ❑No® Contract Type: (Check one)New❑ Renewal ® Amendment ❑ Effective Date 7/1/2014
Approved by Board Yes®No❑ Agenda Date: 6/17/2014 Title of Contract: 2014-15 Outside Agency Performance Agreement
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: q- "n4n-w,Department Director's Signature: s Date: p
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 El. Hold
Contract pending receipt of Certificate of Insurance E]. With incorporation of Insurance provisions as sho
by the Risk Manager: D MITTI
Risk Manager's Signature: Date: AUG 19 2014
Financial Services
This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No A bu
before approval Yes❑No . If budget amendment is necessary, please attach to this form. This instrume s e p -a di
manner required by the Local Government Bu et d Fiscal Control A
A,_ S ¢ 2014
Financial Services Director's Signature: Date:
County Attorney 13y--
Approval by Board ❑ (Contracts $90,000.00 or more for goods or services, $250,000.00 or more for construction, or any
consultant contract). Approval by Wqager CK(Most other contracts$1,000 and above). Department Director approval only❑ (Under
$1,000). This contract has been rev e d and approved by the Attorney as to legal form and sufficiency:
Attorney's Signature Date: q 9'
County Manager
This contract has been reviewed and is approved by the County Manager Yes❑No❑.
This contract has been reviewed an for signature by the Chair Yes❑No❑.
Manager's Signature: Date:
Clerk At4oard
Approved by BOCC on the day of 120 for air signature on the day of ,20
Clerk's Signature: Date: <
Revised March 2012