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DocuSign Envelope ID: C26DF6AF- BFFB- 437D- A831- 77lA06C3lC5A <br />ORANGE COUNTY- DEPARTMENT USE ONLY <br />Department <br />Party/Vendor Name: Patty/Vendor Contact Person: Contact Phone: Party /Vendor Address: <br />City State: Zip: Department: Amount: Purpose: .Budget Code(s): <br />Vendor # (NIA if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check <br />one) New ❑ Renewal ❑ Amendment ❑ Effective Date Approved by Board Yes❑ No❑ Agenda <br />Date: <br />This agreement is approved as to technical form and content: <br />DocuSigned by: <br />Department Director's Signature Date: 11/18/2014 <br />�—:5BCDFFM5A35475 <br />Information Technologies <br />(Applicable only to hardware /software purchases of related services) Ibis agreement has been reviewed and is <br />approved as to information technology content and specifications: <br />Office of the Chief' Information Officer <br />Risk Management <br />Date: <br />Ihis agreement is approved for suff ciency of insurance standards, specifications, and requirements: <br />A1DocuSigned "" by, <br />''� <br />Office of the Risk Management Officer uLISA C,bvin t 1tb Date: 11/20/2014 <br />7FDCF9176800498... <br />Financial Services <br />Ihis instrument has been pre - audited in the manner required by the Local Government Budget and Fiscal Control Act: <br />— ^DocuSigned by: <br />Office of the Chief Financial Officer- Date: 11/20/2014 <br />2F982EC44C2C444... <br />Legal Services <br />This agreement is approved as to legal form and sufficiency: <br />DocuSigned by: <br />Office of the County AttorneyI� A Date: 11/20/2014 <br />4035CB8304CA4A9... <br />Clerk to the Board <br />Received for tecoid retention: <br />All Docusign contracts must be copied to Donna Lloyd upon completion @ Dollo3W@orangecountync. ,yov <br />The following signature block is for hard copies only and is not required for Docusign contracts: <br />Office of the Clerk to the Board <br />Revised 10114 4 <br />Date: <br />