R 2016-212-E Aging - Lauren Shiplett for MAP summer intern

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DocuSign Envelope ID: 14D37718-BEAE-4494-8BD9-AC8FC1C8COOB ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Lauren Shiplett Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: 5819 Acorn Knoll Place City Mebane State: NC Zip: 27302 Department: Aging Amount: $1,350.00 Purpose: MAP Summer Intern Budget Code(s): 10430020-630120 Vendor#62884 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 05/09/16 Approved by Board Yes❑No❑ Agenda Date: This agreement is approved as to technical forth and content: 5zDocuSigned by: &Department Director's Signature fi�v Date:4/18/2016 67E962D1BF454FA... Information Technolosies (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer Date: Risk Management This agreement is approved for sufficiency of insurance standards,specifications,and requirements: DocuSigned by: 11i1 Office of the Risk Management Officer pllS. ('6n' '',ll b Date: 4/19/2016 7FDCF9176800498... Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: DocuSigned by: Office of the Chief Financial Officer Date: 4/19/2016 7D4E5181ACC1409... Legal Services This agreement is approved as to legal form and sufficiency: DocuSigned by: Office of the County Attorney In,_ Date: 4/19/2016 4035CB8304CA4A9... Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloy(d c�orangecount.nic.gov The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board Date: Revised 1/16 4