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DocuSign Envelope ID: 76A32744-ADOD-41DA-81B5-2F410532994B <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Deuartment <br /> Party/Vendor Name: Forum for Youth Investment/Readyby 21 Party/Vendor Contact Person: Karen Pittman Contact <br /> Phone: 202-207-3333 Party/Vendor Address: 7064 Eastern Avenue, NW City Washington State: DC Zip: 20012 <br /> Department: Health Amount: 8750 Purpose: Coaching and consulting services Budget Code(s): 10412020-630000- <br /> 71456 Vendor 4 62972 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check <br /> one)New ® Renewal ❑ Amendment ❑ Effective Date 5-8-15 Approved by Board Yes❑ No❑ Agenda <br /> Date: <br /> This agreement is approved as to to M('�eff1uF&rM id ontent: <br /> (h 5/18/2015 <br /> Department Director's Signature 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 sufficien Fi gce:''sttLandards,specifications,and requirements: <br /> ausa, (hm,&b 5/19/2015 <br /> Office of the Risk Management Office F-BSFQ47-6899449 Date: <br /> Financial Services <br /> This instrument has been pre-audited i q�a � diquired by the Local Government Budget and Fiscal Control Act: <br /> A U� <br /> Office of the Chief Financial Officer o�F�e Date: 6/1/2015 <br /> Legal Services <br /> This agreement is approved as t�r�ftnvftwd sufficiency: <br /> Office of the County Attorneys Date: 6/1/2015 <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ DolloyLyorangecou go v <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 05/15-AMM 4 <br />