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DocuSign Envelope ID: BD71C3CC-39C1-4DAD-9E50-D27C98973D8F <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Deuartment <br /> Party/Vendor Name: Jessica Tufte Party/Vendor Contact Person: Contact Phone: Party/Vendor <br /> Address: 100 Rock Haven Rd, P204 City Carrboro State: NC Zip: 27510 Department: Aging Amount: $3,000 <br /> Purpose: MAP Summer Intern Budget Code(s): 10430020-630120 Vendor 4 N/A (N/A if new vendor) Vendor is a <br /> BOCC consultant? Yes ❑ No❑ Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date <br /> May 1,2015 Approved by Board Yes❑No® Agenda Date: <br /> This agreement is approved as to technic form.pd content: <br /> ocuSigned by: <br /> Department Director's Signature « <br /> Date: 4/18/2015 <br /> B7E962D1BF454FA... <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 f i6[�idip�A""�tal1nlLdards,specifications,and requirements: <br /> Office of the Risk Management Officer a�lSa �,6vvt98_ <br /> Date: 4/20/2015 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in th .Bp&qf�j7gpired by the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer PMAL [,al 6VU Date 4/20/2015 <br /> 232DFFC2CFA847B... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> E_�A ocuSigned by: <br /> Office of the County Attorney 4/20/2015 <br /> � Date: <br /> 4035CB8304CA4A9... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ DolloyLyorangecoun.nc.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 />