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DocuSign Envelope ID:OD9EF802-8779-4DF5-9500-E911A4113333 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Bruce Gillooly Party/Vendor Contact Person: Contact Phone: Party/Vendor <br /> Address: 346 Chatham Dr City Chapel Hill State: NC Zip: 27516 Department: Aging Amount: $3,000.00 Purpose: <br /> senior centers instructor Budget Code(s): 10430120-629000 Vendor 4 51330 (N/A if new vendor) Vendor is a <br /> BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New ❑ Renewal ® Amendment ❑ Effective Date <br /> July 1,2015 Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is approved as to techni of9e content: <br /> ,iGt 'r <br /> Department Director's Signature y Date: 7/1/2015 <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 of insurance standards,specifications,and requirements: <br /> DocuSigned""by: <br /> ''1L <br /> QllStU (hVV,&b <br /> Office of the Risk Management Officer Date: 7/2/2015 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner re uired by the Local Government Budget and Fiscal Control Act: <br /> DocuSigned b <br /> Office of the Chief Financial Officer <br /> blti Date: 7/2/2015 <br /> 232DFFC2CFA847B... <br /> Legal Services <br /> This agreement is approved as to 74035CB8304CA4Ag ar��sufficiency: <br /> goe y: <br /> 7/2/2015 <br /> Office of the County Attorney � Date: <br /> ... <br /> Clerk to the Boa rd <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 10/14 4 <br />