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ORANGE COUNTY---DEPARTMENT USE ONLY---HARD COPY ONLY <br /> Department <br /> Party/Vendor Name: Town of Carrboro Party/Vendor Contact Person: Holly Holland Contact Phone: <br /> Party/Vendor Address: 301 W Main St City Carrboro State:NC Zip: 27510 Department: Aging Amount:I&M <br /> Purpose: Senior Lunch Program Budget Code(s): 10430105-449001-71086,/Vendor # 595 (N/A if new, vendor) 1l q(lq <br /> Vendor is a BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New ❑ Renewal ® Amendment ❑ l <br /> Effective Date 7/01/17 Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> Department Director's Signature Date: 6-1.1f-l7 <br /> Information Technolozies <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 Risk Management ( tom- 1�i �J� Date: I <br /> Financial Services <br /> This instrument has been pre-audited in the a re wired the Local Government Budget and Fiscal Control <br /> Act: <br /> Office of the Chief Financial Officer Date:?45A7 <br /> Leal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> Office of the County Attorney L Aty fz'(&-"' _Date: 'l l t 1-i <br /> Clerk to the Board <br /> Received for record retention: <br /> Office <br /> of the Clerk to the Board Date:J1 (t l(1 <br /> Revised 2/17 <br />