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DocuSign Envelope ID:OE1DC452-5230-4006-AO02-D10A4OC3FE6F <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Jeanine Gangloff Party/Vendor Contact Person: Jeanine Gangloff Contact Phone: 919-260-2772 <br /> Party/Vendor Address: 934 Split Rail Lane City Hillsborough State: NC Zip: 27278 Department: DEAPR-Recreation <br /> Amount: $810.00 Purpose: Preschool Program instruction Budget Code(s): 10511020 630000 Vendor#N/A (N/A if <br /> new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ <br /> Amendment ❑ Effective Date 1!1!2015 Approved by Board Yes❑No® Agenda Date: <br /> This agreement is approved as to to 8831u, 9 d c went: <br /> Department Director's Signature 761 1CFA1 D507A495 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 Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficiency, �ftpvU3v;tandards, specifications, and requirements: <br /> �EiaDcE_cLLzaa0DA_q&_Office of the Risk Management Officer _ Date: <br /> Financial Services <br /> This instrument has been pre-audited i 17DocAicged required by the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer 2F9e2EC44C2C444... Date: <br /> Legal Services <br /> This agreement is approved as t e �i�figd�ltl sufficiency: <br /> a 1°ekxfs <br /> Office of the County Attorney Eesann6eese5 Date: <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dollo. dLC orangecount n�c.gov <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 Date: <br /> Revised 10/14 4 <br /> DS <br /> D <br />