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DocuSign Envelope ID:447D9587-9945-4A94-A452-8EDF7406B837 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Deuartment <br /> Party/Vendor Name: Julia Katz Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: <br /> 105 Fidelity Street, B17 City Carrboro State: NC Zip: 27510 Department: Aging Amount: $3,000 Purpose: MAP <br /> Summer Intern Budget Code(s): 10430020-630120 Vendor 4 N/A (N/A if new vendor) Vendor is a BOCC <br /> consultant? Yes ❑No❑ Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date Maw <br /> 2015 Approved by Board Yes❑No® Agenda Date: <br /> This agreement is approved as to techni.Cal form and content: <br /> ocuSigned by: <br /> - <br /> Department Director's Signatur �U_ �-� 5/15/2015 <br /> y bur Date: <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 /> ''11 <br /> QllStU (hVVt&b 5/18/2015 <br /> Office of the Risk Management Officer Date: <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited i D c�,.quired by the Local Government Budget and Fiscal Control Act: <br /> pm/,L �,o+bvu 5/25/2015 <br /> Office of the Chief Financial Officer Date: <br /> 232DFFC2CFA8478... <br /> Legal Services <br /> This agreement is approved as to C.�,m sufficiency: <br /> Office of the County Attorney 1� Date: 5/26/2015 <br /> 035CB8304CA4A9... <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 />