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DocuSign Envelope ID:AC302E60-1CB4-4308-8830-306C67884AEA <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Deuartment <br /> Party/Vendor Name: Chapel Hill Institute for Cultural and Language Education Party/Vendor Contact Person: Perla <br /> Saitz Contact Phone: 919-933-0398 Party/Vendor Address: 101 East Weaver St_ G-1 City Carrboro State:NC Zip: <br /> 27510 Department: Aging Amount: $10,000 Purpose: senior centers instructor Budget Code(s): 10430120-629000 <br /> Vendor 4 43840 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) <br /> New ❑ Renewal ® Amendment ❑ Effective Date September 10, 2015 Approved by Board Yes❑ No❑ <br /> Agenda Date: <br /> This agreement is approved as to technical 5 <br /> rm nd content: <br /> ocu igned y: <br /> Department Director's Signature <br /> [_� '«' -Ar Date: 9/28/2015 <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 /> ''111L <br /> Office of the Risk Management Officer a�lSa (,bnU& Date: 9/29/2015 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> DocuSign"_ed by: <br /> Office of the Chief Financial Officer P� lA l,(.1-bVU Date: 9/30/2015 <br /> 232DFFC2CFA847B... <br /> Legal Services <br /> This agreement is approved as to le of flog n��d sufficiency: <br /> Office of the County Attorne 44 Date: 10/5/2015 <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 />