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ORANGE COUNTY—DEPARTMENT USE ONLY n / <br /> o/r/. / <br /> Department p� (p <br /> Party/Vendor Name: Chapel Hill Carrboro City SchoolsParty/Vendor Contact Person: Rydell Harrison Contact <br /> Phone: 919-967-8211 Party/Vendor Address: 750 S. Merritt Mill Road City Chapel Hill State: NC Zip: 27516 <br /> Department: Health Amount: $60,404Purpose: Provide Summer K-Readiness program Budget Code(s): 10412020 <br /> 630000-71453Vendor#22226 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type: CAVW Ian; <br /> (Check one) New ❑ Renewal X Amendment F] Effective Date 5/221/17Approved by Board Yes❑ No❑ <br /> Agenda Date: <br /> This agreement is approved as to technical form and content: 2� J <br /> Department Director's Signature Date: /1.J <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 /> Office of the Risk Management Officer d-r..- L Date: / <br /> Financial Services <br /> This instrument has been pre-audited in the m r re ' d b the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer Date: 7 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> Office of the County Attorney Au 6�� Date: U ACA-1 <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd compl . @ Dolloydgorangecount nc.gov <br /> The following signature block is for hard copie' 1 is of re uire for Docusign contr7W?Office of the Clerk to the Board Date: <br /> Page 6 of 6 <br /> Revised 512016 <br />