R 2016-497-E Aging - CHICLE Language Institute for class instructor

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DocuSign Envelope ID:OF057OB4-4262-4BBE-8F68-616C28CC34D6 ORANGE COUNTY-DEPARTMENT USE ONLY Department Party/Vendor Name: CHICLE Language Institute Party/Vendor Contact Person: Perla Saitz Contact Phone: 919-933- 0398 Party/Vendor Address: 109 Conner Dr., Ste 2200 City Chapel Hill State: NC Zip: 27514 Department: Aging Amount: $14,950 Purpose: class instructor Budget Code(s): 10430120-629000 Vendor#43840 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ Effective Date 09/01/2016 Approved by Board Yes❑No❑ Agenda Date: This agreement is approved as to technical form and content: 5igned by: Department Director's Signature 8/29/2016 5z& Date: 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: FaDocuSigned b y: 1111 Office of the Risk Management Officer llSA. ('6nttN Date: 8/29/2016 7FDCF9176800498... Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: gned by: Office of the Chief Financial Officer DocuSi � .�1 Date: 8/29/2016 7D4E5181ACC1409... Legal Services This agreement is approved as to legal form and sufficiency: ocuSigned by: Office of the County Attorney Date: 8/29/2016 4035CE8334CA4A9... 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 6/16 4