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DocuSign Envelope ID:8C992E8F-344C-4404-AO07-436 FO BCD 1197 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: L.I.F.E. Skills Foundation Party/Vendor Contact Person: Alex Protzman Contact Phone: <br /> (919) 265-9667 Party/Vendor Address: 2670 Durham-Chapel Hill Blvd City Durham State: NC Zip: 27707 <br /> Department: Social Services Amount: 517.000.00 Purpose: Fostering Youth Opportunities Budget Code(s): <br /> Vendor 9 N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ Nog Contract Type: (Check one) <br /> New ® Renewal ❑ Amendment ❑ Effective Date July 1. 2015 Approved by Board Yes❑No® Agenda <br /> Date: <br /> This agreement is approved as to technical formr_N "d by: <br /> A 1n.Cl� (hS 6v, 6/11/2015 <br /> Department Director's SignatureE,�,ssAes Date: <br /> Information Technologies <br /> (Applicable only to hardware/sofhvare 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 of insur sffimfilaDd5;'sppecifications, and requirements: <br /> Q�ASA. r,6Vlit,t�0 <br /> Office of the Risk Management Officer Date: 6/12/2015 <br /> �BCF�'Y769H0#9... <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: DocuSigned by: <br /> �M/,L to D""`bvu 6/29/2015 <br /> Office of the Chief Financial Officer DF- FAB4ZB Date: <br /> Leual Services <br /> This agreement is approved as to legal form and suf q igned by: <br /> Office of the County Attorney 1 Date: 6/29/2015 <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd @,orangecountync.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 10114 <br /> S <br />