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DocuSign Envelope ID: E7E41114-899E-4363-B04E-5C9923EE95E8 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Sharon Lynn PUne Party/Vendor Contact Person: Contact Phone: Party/Vendor <br /> Address: 121 N Nash Street City Hillsborough State:NC Zip: 27278 Department: Aging Amount: $3,000 Purpose: <br /> senior centers instructor Budget Code(s): 10430120-629000 Vendor 4 62251 (N/A if new vendor) Vendor is a <br /> BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New ❑ Renewal ® Amendment ❑ Effective Date <br /> September 15,2015 Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is approved as to technical <br /> Egrm and content: <br /> Department Director's Signature Date 9/20/2015,iGt 'r : <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:''1L <br /> Q�AS#, r,6vvt,e 6 9/21/2015 <br /> Office of the Risk Management Office Date: <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the m nn r regVired by the Local Government Budget and Fiscal Control Act: <br /> �ocu�igned-by: <br /> Office of the Chief Financial Officer <br /> bVu Date: 9/21/2015 <br /> 232DFFC2CFA847B... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: <br /> Office of the County Attorney <br /> L16 k Date: 9j23/2015 <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 />