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DocuSign Envelope ID:OEFB7BD2-EFC4-4E6C-9652-A24E637761 F3 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Wade Heveriv Party/Vendor Contact Person: Wade Heveriv Contact Phone: 919.451.9499 <br /> P artyNendor Address: 1117 Ranger Drive City Hillsborough State: NC Zip: 27278 Department: DEAPR Amount: <br /> $1600.00 Purpose: Volleyball Camp Budget Code(s): 10511020 630000 Vendor # 62401 (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal ❑ Amendment ❑ <br /> Effective Date April 25,2016 Approved by Board Yes No Agenda Date: <br /> This agreement is approved as to technica r 004���htent: <br /> 10 Department Director's Signature �`�� Date: 4/25/2016 <br /> 0-I-I C.r,/A TUUM <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 o 'a� specifications, and requirements: <br /> 10 QuSA. r,Ovv�c,116 4/25/2016 <br /> Office of the Risk Management Officer Date <br /> lmv� <br /> F�� : <br /> Financial Services <br /> This instrument has been pre-audited in the ��e�imed by the Local Government Bu dget and Fiscal Control Act: <br /> °n*�� 4/28/2016 <br /> Office of the Chief Financial Officer Date:-+v Z7... <br /> L) D_1 <br /> C) <br /> Legal Services <br /> This agreement is approved as to leg o^ 4a ciencyo <br /> 4/28/2016 <br /> Office of the County Attorney FAA3 n33EIMn8465 Date: <br /> Clerk to the Board <br /> Re ceived for record retention: <br /> All Do cus ign contracts must b e cop ied to Donna Lloyd upon completion @ D ollovd(a)oranaecountaic.aov <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 1/16 4 <br /> DS <br /> cs <br />