HomeMy WebLinkAboutR 2010-104 Co Manager - Charles House Association amendment ORANGE COUNTY—CONTRACT CONTROL SHEET 10
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: Charles House Assoc. Party/Vendor Contact Person: Paul Klever Contact Phone: 919-967-7570 Party/Vendor
Address: 109 Hillcrest Ave. City Carrboro State:NC Zip: 27510 Department: Outside Agency Amount: $9,000 Purpose:
Budget Code(s): 10495050 710029 Vendor#800031 (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 L� his contract has been reviewed and approved by the Department Director as to
technical content:
Department Director's Signature: Date: t�—
1 'rector
(Applicable only to hay dware/software purchases or related servic his cont ct has been reviewed and approved by the Information
Technology Director as to technical content and information ology cifications:
IT Director's Signature: Date:
Risk Management
Include the following coverages: D�CGL; Auto; F!� 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 Si nature: Date: 8 trz)tlo
Financial Services
This Contract is conditioned pon appropriation by the Board of Commissioners Yes❑Nog A budget amendment is necessary
before approval Yes❑ No�f.. 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: I
Financial Services Director's Signature: / � - Date: 1
g qav(,�vUl A
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 Man e ❑ (All other contracts). This contract has been reviewed and approved by the Attorney as to legal
form and sufficiency:
Attorney's Signature Date:11 1 1c7
County Manager
This contract has been reviewed and is approved by the County Manager YvEj No❑.,
This contract has been reviewed and is to be submitted for BOCC consideration YPsMNo❑.
Manager's Signature: Date: (6 11 d
C 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: .l Z
Revised April 2010