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DocuSign Envelope ID:OFODCF4C-1F4D-468E-94D2-BAF19E66444B <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Menggi Jiang Party/Vendor Contact Person: Contact Phone: Party/Vendor <br /> Address: 304 Copperline Dr., Apt G City Chapel Hill State: NC Zip: 27516 Department: Aging Amount: $3,600 <br /> Purpose: Master Aging Plan Summer Intern Budget Code(s): 10430020-630120 Vendor#63781 (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ <br /> Effective Date July 1,2016 Approved by Board Yes❑No[] Agenda Date: <br /> This agreement is approved as to technical form gnd content: <br /> hh ocuSigne by: <br /> J <br /> Department Director's Signature Date: 6/16/2016 A.�tdGt� <br /> 67E962D18F454FA... <br /> Information Technolosies <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 /> Docu5igned""by: <br /> ''11i1 <br /> Office of the Risk Management Officer aus . (,Orvt16 Date: 6/17/2016 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner rsequired by the Local Government Budget and Fiscal Control Act: <br /> ocuSigned y: <br /> Office of the Chief Financial Officer F�!N Date:6/17/2016 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legapforsmnand sufficiency: <br /> Office of the County Attorney Date: 6/17/2016 <br /> 4035CE8304CA4A9... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloy(d c�orangecount.nic.gov <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 6/16 5 <br />