HomeMy WebLinkAboutR 2014-407 Finance - Dispute Settlement Center, Inc. - Outside Agency Performance Agreement ar - ` 7
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: Dispute Settlement Center,Inc. Party/Vendor Contact Person: Frances Henderson Contact Phone: 919-919-8800
Party/Vendor Address: 302 West Weaver St. City Carrboro State:NC Zip:27510 Department: Finance&Admin. Services Amount:
$76,000 Purpose: Performance Agreement Budget Code(s): 10495050-710003 Vendor#800029 (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:
Department Director's Signature: Date:
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 Manazement
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, this contract is approved
by the Risk Manager:
Risk Manager's Signature: i' _� Date: c)
Financial Services
This Contract is conditioned pon appropriation by the Board of Commissioners Yes❑No[d A budget amendment is necessary
before approval Yes❑No[VI. If budget amendment is necessary,please attach to this form. This instrument has been pre-audited in the
manner required by the Local Government Bud r)and Fiscal Control Act:
Financial Services Director's Signature: C_j Date:
1616
County Attorney
Approval by Board ❑ (Contracts $90,00 or more for goods or services, $250,000.00 or more for construction, or any BOCC
consultant contract). Appro y Managert(Most other contracts$1,000 and above). Department Director approval only ❑ (Under
$1,000). This contract has b e viewed and 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[g4oEl.
This contract has been reviewed and is for signature by the Chair Yes❑No❑.
Manager's Signature: Date:
erk 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