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DocuSign Envelope ID:A42223B2-31 FD-4913-906A-DD240B680520 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Benjamin Beaton Party/Vendor Contact Person: Same Contact Phone: 517-740-6785 Party/Vendor <br /> Address: 107 James Helen Ct. City Willow Spring State: NC Zip: 27592 Department: HHR&CD Amount: $15.000 <br /> Purpose: HHR&CD Budget Code(s): Vendor#59063 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ <br /> No[] Contract Type: (Check one)New❑ Renewal ❑ Amendment ® Effective Date April 1,2016 Approved by Board <br /> Yes❑Nor-1 Agenda Date: <br /> This agreement is approved as to tec 7A13FC071F0B64E0�q`ft�1P1t% content: <br /> a_k"`"""`"d' °" d 4/21/2016 <br /> Department Director's Signature _ D ate: <br /> Information Technolosies <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is approved as to <br /> information technology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficiency nmanAw-cwtandards, specifications,and requirements: <br /> gusa. (hnt N 4/21/2016 <br /> Office of the Risk Management Officer Date: <br /> Financial Services <br /> This instrument has been pre-audited i e`loft! YP�quired by the Local Government Budget and Fiscal Control Act: <br /> �" `�°""`��°" 6/21/2016 <br /> Office of the Chief Financial Officer 7o4E5181ACC1409_ Date: <br /> Legal Services <br /> This agreement is approved as to pf na*&sufficiency: <br /> Office of the County Attorney` Date: 6/23/2016 <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloydkorangecount.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 3/16 <br />