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DocuSign Envelope ID: 08D3FFFC-123C-4F6F-ABB7-392A54BA5E09 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> NOT A CONTRACT EXHIBIT OR ATTACHMENT <br /> Department <br /> Party/Vendor Name: Music and Dance Productions Party/Vendor Contact Person: Wesley Boz Contact Phone: <br /> Party/Vendor Address: P O Box 728 City Franklinton State:NC Zip: 27525 Department: Aging Amount: $6,000.00 <br /> Purpose: Dance Classes Budget Code(s): 10430120-629000 Vendor # 61488 (N/A if new vendor) Vendor is a <br /> BOCC consultant? Yes ❑No® Contract Type: (Check one)New❑ Renewal ® Amendment ❑ Effective Date <br /> 10/01/14 Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is approved as to technical form c RTIFII . by: <br /> ,Oa&(& J`, (tr 10/1/2014 <br /> Department Director's Signature R7F967D9RF4541-A Date: <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 » ''""standards,specifications,and requirements: <br /> Qusa, (hVVIA6 10/6/2014 <br /> Office of Risk Management_ F� G „� , -- Date: <br /> Financial Services <br /> This instrument has been pre-audited in the eP4�l�"d1by the Local Government Budget and Fiscal Control Act: <br /> ��.�ti 10/6/2014 <br /> Office of the Chief Financial Officer �F9R�FCA4(7(A44 Date: <br /> Legal Services <br /> This agreement is approved as to legal fo I%f leicy: <br /> Office of the County Attorney 44J4 Iws- Date: 10/9/2014 <br /> Clerk to the Board <br /> Received for record retention: DocuSignea by: <br /> v6V,V A. 154W 10/10/2014 <br /> Office of the Clerk to the Board 7-E-61-BaF-6Ga7B4DF: Date: <br /> Revised 7/14 4 <br />