Orange County NC Website
DocuSign Envelope ID:4C66C6C0-0395-484C-B2FB-375ED35FBD84 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Deuartment <br /> Party/Vendor Name: Maureen Devlin Party/Vendor Contact Person: Contact Phone: Party/Vendor <br /> Address: 112 Daffodil City Carrboro State: NC Zip: 27510 Department: Aging Amount: $4,000 Purpose: Master <br /> Aging Plan Summer Intern Budget Code(s): 10430020-630120 Vendor# 63779 (N/A if new vendor) Vendor is a <br /> BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New® Renewal❑ Amendment ❑ Effective Date <br /> 05/09/16 Approved by Board Yes❑Nor-1 Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> DuSigned by: <br /> Department Director's Signature 5:(& fi�v Date: 5/5/2016 <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 /> ''11ii <br /> Office of the Risk Management Officer Fausa, vv�cal6 Date: 5/5/2016 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the pagnere yquired by the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer el� Date: 5/5/2016 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> Office of the County Attorney s Date: <br /> 5/5/2016 <br /> 4035CB8334CA4A9... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ DolloydL&oranaecountync.Qov <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 />