HomeMy WebLinkAboutR 2010-070 Co Manager - Planned Parenthood of Central NC outside agency agreement 6 --70
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: Planned Parenthood of Central NC Party/Vendor Contact Person: Janet Colm Contact Phone: 919-929-5402
Party/Vendor Address: O.O. Box 3258 City Chapel Hill State:NC Zip: 27514 Department: Outside Agency Amount: $$10,000
Purpose: Budget Code(s): 10495050 710013 Vendor# 800040 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑
No® Contract Type: (Check one)New❑ Renewal® Amendment ❑ Effective Date July 1,2010 Approved by Board Yes®No
❑ Agenda Date: June 15,2010 Title of Contract: 2010-11 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 is co t t has been reviewed and approved by the Department Director as to
technical content:
Department Director's Signature: Cj ate: T__ 4�
I irector L k
(Applicable only to hardware/software purchases or related services)This contract ha een 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: ErCGL; Auto; C;,3"Professional; ❑ Property; ❑ OR No Insurance Required El. Hold
Contract pending receipt of Certificate of Insurance With incorporation of Insurance provisions as shown, this contract is approved
P g P � P
by the Risk Manager:
Risk Manager's Signature: W Date:
Financial Services
This Contract is conditioned pon appropriation by the Board of Commissioners Yes❑NoY- A budget amendment is necessary
before approval Yes[:]No& 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 et and Fiscal fC,ontrol Act: �i
Financial Services Director's Signature: NA4�W /y* J/14)L� Date: (I }o
County Attorney
Approval by Board ❑ (Contracts over $90,000.00 for goods or services, $250,000.00 for construction, or any BOCC consultant
contract). Approval by Manag X(A other contracts). This contract has been reviewed and approved by the Attorney as to legal
form and sufficiency:
Attorney's Signature Date: I°l 2-Ls 0
County Manager
This contract has been reviewed and is approved by the County Manager YNo❑.
This contract has been reviewed and is to be submitted for BO C consideration Yes❑No❑.
Manager's Signature: Date: 23
�Ierk to the Board
Approved by BOCC on the day of 0 Submitted for Chair signature o the day of 320
Clerk's Signature: D e: LAG (J
Revised April 2010