R 2015-209-E DEAPR - U.S. Tae Kwon Do Center, Inc. for tae kwon do instruction

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DocuSign Envelope ID:210FB50F-D15E-4627-BB63-FOBBF5AA7B2F ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: U.S. Tae Kwon Do Center, Inc. PartyNendor Contact Person: Steve Kim Contact Phone: (919)730-3697 PartyNendor Address: 15201 Rose Garden Lane City Durham State: NC Zip: 27707 Department: DEAPR Amount: $4797.00 Purpose: Tae Kwon Do Instruction Budget Code(s): 10511020 630000 Vendor# 61681 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date Apt-it 28,2015 Approved by Board Yes❑No❑ Agenda Date: This agreement is approved as to teclrrtic a el��s7tent: Lt� Department Director's f-Alt)t Date; 5/4/2015 Information Technologies (Applicahle only to hardtt,are/sq/Iii,ar'e purchases or relale(l services)This agreement has been reviewed and is approved as to information tecluiology content and specifications: Office of the Chief Information Officer Date: Risk Management This agreement is approved for sufficiency of in 77FDCF9176800498...Wk'' RtiEtht'rds specifications,and requirements: Us& M 5/11/2015 Office of the Risk Management Officer Date: Financial Services This instrument has been pre-audited in the tsiegsrggaiiw-d by the local Government Budget and Fiscal Control Act: r A tL to D""`bvu 5/12/2015 Office of the Chief Financial Officer Date: 232DFFC2CFA8478... Legal Services This agreement is approved as to I a^�¢fYr�' � Sciency: J 5/12/2015 Office of the County Attorney- EAA3D33E�8A8465 Date: Clerk to the Board Received for record retention: All Docusign contracts mist be copied to Donna Lloyd upon completion fir Dolloyd c,orangccotuiityig.gov The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board Date: Revised 16/14 ff