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o4-�� <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Town of Chapel Hill Party/Vendor Contact Person: Jackie Thompson Contact Phone: <br /> Party/Vendor Address: 405 Martin Luther King Jr. Blvd. City Chapel Hill State: NC Zip: 27514 Department: <br /> Aug Amount: $12,300.00 Purpose: RSVP Budget Code(s): 10434005-448910 Vendor # 64 (N/A if new <br /> vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal <br /> 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 A,g�e�L Date: ' S <br /> Information Technologies <br /> (Applicable only to hardware/software 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 �p-�_ -i��� Date: <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: Q G <br /> Office of the Chief Financial Officer Nz� Date: % Y <br /> Legal Services <br /> This agreement is approved as to legal fo a sufficiency: <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 Date: / V,,iv <br />