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DocuSign Envelope ID:8B974F86-8438-416C-9F8D-33AE69D5D195 <br /> ORANGE COUNTY---DEPARTMENT USE ONLY---HARD COPY ONLY <br /> Department <br /> Party/Vendor Name: Carpe Diem Party/Vendor Contact Person: Trish Halsey Contact Phone: 919-929-7087 <br /> Party/Vendor Address: PO Box 2414 City Chapel Hill State:NC Zip: 27515-2414 Department: CTY MGR/CJRO <br /> Amount: $120 per referral Purpose: Substance Use Education Budget Code(s): 10212020-720133 Vendor#N/A <br /> (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ <br /> Renewal❑ Amendment ❑ Effective Date Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> Department Director's Signature Date: <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 /> Office of Risk Management ((USX (OVtU. t Date: <br /> �---7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: <br /> DocuSigned by: <br /> Office of the Chief Financial Officer (21.4-N An Date: <br /> `---7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency:.Signed by: <br /> Office of the County Attorney i°' "-S Date: <br /> 328DC480549A4F5... <br /> Clerk to the Board <br /> Received for record retention: <br /> Office of the Clerk to the Board Date: <br /> Revised 6/16 <br />