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y <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Town of Carrboro Party/Vendor Contact Person: Holly Holland Contact Phone: 919-918- <br /> 7318 Party/Vendor Address: 301 W. Main Street City Carrboro State: NC Zip: 27510 Department: Acing <br /> Amount: $5,000 Purpose: Senior Lunch Program Budget Code(s): 10430105-449001-71086 Vendor#595 (N/A if <br /> new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one)New ❑ Renewal <br /> Amendment ❑ Effective Date 07/01/2015 Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> Department Director's Signature aageez Date: 9-9-/.S <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 /> Office of the Risk Management Officer Gam! Date:�5 <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: 12A 15- <br /> Office of the Chief Financial Officer 4 11161 Date: q l n <br /> IV <br /> G� <br /> Lezal Services <br /> This agreement is approved as to legal fo d sufficiency: <br /> Office of the County Attorney Date: ?( V) <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@oran eg countync•gov <br /> The following signature block is for hard o y is not required for Docusign contras s: <br /> Office of the Clerk to the Board Dat . Ke /� <br />