HomeMy WebLinkAboutR 2016-288 Health - Chapel Hill Carrboro City Schools to provide summer K-Readiness program i
ORANGE COUNTY-CONTRACT CONTROL SHEET (0
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. ,^ ( n / �j
Department To*t(PV au,& I
Party/Vendor Name: Chapel Hill Carrboro City Schools Party/Vendor Contact Person: Sheldon Lanier Contact Phone: 919-967-8211 /
x28247 Party/Vendor Address: 750 S.Merritt Mill Rd. City Chapej Hill State:NC Zip:27516 Department:Health Amount:$45,540 Y
Purpose:Provide Summer K-Readiness program Budget Codes 10412020-681000-71453 Vendor#22226 (N/A if new vendor)
Vendor is a BOCC consultant? Yes❑No® Contract Type:(Check one)New❑ Renewal® Amendment ❑ Effective Date 5/1/16
Approved by Board Yes❑No❑ Agenda Date: Title of Contract:CHCCS Kinder Jump Outside Agency 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❑Non Bid/RFP number This contract has been reviewed and approved by the Department Director as to
technical content:
JJ
Department Director's Signature: Date: �P-
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 Require ❑. Hold
Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as shown,this contract is approved
by the Risk Manager: t
Risk Manager's Signature: ��1.�-� ti�`~"�-_ Date:
Financial Services
This Contract is conditioned upon appropriation by e Board of mmissioners Yes❑No❑. A budget amendment is necessary
before approval Yes❑No❑. If budget amendm is ne ssary lease attach to this form. This instrument has been pre-audited in the
manner required by the Local Government Budge d F. al o of Act: ff
Financial Services Director's Signature: Date: b
Ix County Attorney
Approval by Board ❑ (Contracts $90,00 00 or more for goods or services, $250,000.00 or more for construction, or any BOCC
consultant contract). Approval b Manager%K(Most other contracts$1,000 and above). Department Director approval only F] (Under
$1,000). This contract has been v ed an proved by the Attorney as to legal form and sufficiency:
Attorney's Signature Date: (0 1 J
County Manager
This contract has been reviewed and is approved by the County Manager Yes❑Non.
This contract has been reviewed an 's for si>aature by the Chair Yes❑No❑.
Manager's Signature: Date: C</'
Cler to the Board
Approved by BOCC on the,day ,20 . Submitted for Chair signature on the_day of 20
Clerk's Signature: tl, ff
g / Date: J l�
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Revised March 2012