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DocuSign Envelope ID: DCCF8247-909F-423A-AB78-8E5980B981EE <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> NOT A CONTRACT EXHIBIT OR ATTACHMENT <br /> Department <br /> Party/Vendor Name: U.S. Tae Kwon Do Centel', Inc. Party/Vendor Contact Person: Steve Kim Contact Phone: <br /> (919)730-3697 Party/Vendor Address: 15201 Rose Garden Lane City Durham State: NQ Zip: 27707 Department: <br /> DEAPR Amount: $7718,00 Purpose: Tae Kwon Do Instruction Budget Code(s): 105 1 1020 630000 Vendor H 61681 <br /> (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ NoM Contract Type: (Check one)New M Renewal <br /> ❑ Amendment ❑ Effective Date October 9,2014 Approved by Board Yes❑Non Agenda Date: <br /> This agreement is approved as to technical 'audg6mvit: <br /> Department Director's Signature stat"A Date: 10/13/2014 <br /> 7A49b <br /> Information Technologies <br /> (Applicable on1j,to hardwai-elsofhvai-e pio-chases or i•elated 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 suffici' admgwauWe standards,specifications,and requirements: <br /> Office of Risk Management FaUsa. Date: 10/13/2014 <br /> Financial Services <br /> 'riiis instrument has been pre-audited in the wuMift.d by the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer 7 _)U A�,� Date: 10/13/2014 <br /> 444---- - <br /> Legal Services <br /> This agreement is approved as to legal QnI1tf�lciercy: <br /> 10/13/2014 <br /> Office of the County Attorney Date: <br /> Clerk to the Board <br /> Received for record retention: DocuSigned by: <br /> ,6LA-n U 150kw 10/14/2014 <br /> Office of(lie Clerk to the Board 087 DE Date: <br /> Revised 7114 DS <br /> ff <br />