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DocuSign Envelope ID:OCED799C-A8EC-4781-8322-855CF5C6CFFA <br /> ORANGE COUNTY- TOWN OF CHAPEL HILL ROUTING <br /> Department <br /> Party/Vendor Name: Town of Chapel Hill Party/Vendor Contact Person: Roger Stancil Contact Phone: 919-968- <br /> 2743 Party/Vendor Address: Town Hall,Third Floor, 405 Martin Luther King Jr. Blvd. City Chapel Hill State: <br /> NC Zip: 27514 Department: Manager's Office Amount: 120,000.00 Purpose: County Grant Budget Code(s): <br /> 34600020-900049 Vendor# 64 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No Contract <br /> Type: (Check one) New ❑ Renewal ❑ Amendment ® Effective Date January 1, 2016 Approved by Board <br /> Yesx®No❑ Agenda Date: 11/17/15 <br /> This agreement is approved as to tec :•clbiftnaddAd content: <br /> PWl f jA.ss t 12/14/2015 <br /> Department Director's Signature _ GP Au3 nS 89b4e Date: <br /> SXwc $44,1 <br /> Department Director's Signature 37RIl4FFACLB Date: 12/22/2015 <br /> Legal Services <br /> This agreement is approved as to legal form an f i y•by: <br /> Office of the Town of Chapel A44s;otur <br /> by 2041* );,as Date <br /> 12/15/2015 <br /> ^bl m`� eQSf���aoo... <br /> J uA I`o 12/30/2015 <br /> Office of the County Attorney Date: <br /> Risk Management <br /> This agreement is approved for sufficiency 7anaicoNstandards, specifications,and requirements: <br /> ar,Ortntht 12/22/2015 <br /> Office of the Risk Management Officer Date: <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@orangecountync.gov <br />