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-�►14 ' <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Town of Chapel Hill Party/Vendor Contact Person: Jackie ThoWson Contact Phone: <br /> Party/Vendor Address: 405 Martin Luther King Jr. Blvd. City Chapel Hill State: NC Zip: 27514 Department: <br /> Aging Amount: $15,000.00 Purpose: Senior Lunch Program Budget Code(s): 10430105-449000-71086 Vendor# <br /> 64 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one)New ❑ <br /> Renewal ❑ Amendment ❑ Effective Date 07/01/2014 Approved by Board Yes❑ No❑ Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> Department Director's Signature .i Date:(/1F <br /> Information Technologies <br /> (Applicable only to hardwareIsoftware purchases or related services)This agreement has been reviewed and is <br /> approved as to information technology content and specifications: <br /> Office of the Director of Information Technology Date: <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> Office of Risk Management 11--- // ( - Date: 7 <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: <br /> Office of the Chief Financial Officer vl N%�'1�G✓ ,�• Ale— Date: <br /> Legal Services <br /> This agreement is approved as to legal fo ufficiency: <br /> Office of the County Attorney Date: <br /> Clerk to the Board <br /> Received for record retention: <br /> Office of the Clerk to the Board—hA�� Dater. 7 <br />