Orange County NC Website
DocuSign Envelope ID:4610B145-8FA1-4F53-9A6E-94927D2DB372 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Deuartment <br /> Party/Vendor Name: Reikan Lin Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: <br /> 122 Friar Ln City Carrboro State: NC Zip: 27510 Department: Aging Amount: $3,000 Purpose: MAP Summer <br /> Intern Budget Code(s): 10430020-630120 Vendor 4 N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes <br /> ❑No❑ Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date May 20 2015 Approved <br /> by Board Yes❑No® Agenda Date: <br /> This agreement is approved as to technical fc�xgne�d content: <br /> ocu, ( <br /> Department Director's Signature iU ur Date: 7/21/2015 <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: 7/21/2015 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in th 1R�gerdequired by the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer pm/,L �bin, Date: 7/22/2015 <br /> 232DFFC2CFA847B... <br /> Legal Services <br /> This agreement is approved as to le 1 foy'm ppd sufficiency: <br /> �ocu gne�by: <br /> Office of the County Attorney ✓ gli— Date: 7/22/2015 <br /> 4035CB8304CA4A9... <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 10/14 4 <br />