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DocuSign Envelope ID:3E85CCE1-2986-4C79-97EF-1121BEFDOD13 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Jason Zwilling Party/Vendor Contact Person: Jason Zwilling Contact Phone: (917) 790-9685 <br /> Party/Vendor Address: 2406 Uphill Court City Hillsborough State: NC Zip: 27278 Department: DEAPR Amount: <br /> $945.00 Purpose: Capoeira Instruction Budget Code(s): 10511020 630000 Vendor # 64346 (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ <br /> Effective Date 7/26/17 Approved by Board Yes❑No Agenda Date: <br /> This agreement is approved as to tec n a1T(� �a d content: <br /> V s OWL 7/28/2017 <br /> Department Director's Signature 611CFA1D507A495... Date: <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is <br /> approved as to information technology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficienc o 14fi Ee§tllandards, specifications,and requirements: <br /> QUSX 1'wUib 7/31/2017 <br /> Office of the Risk Management Officer 7FDCF9176800498... Date: <br /> Financial Services <br /> This instrument has been pre-audited i eDPf i Ittquired by the Local Government Budget and Fiscal Control Act: <br /> (21' '�°"' '°', 7/31/2017 <br /> Office of the Chief Financial Officer 714F51R1ACC1409 Date: <br /> Legal Services <br /> This agreement is approved as t eggfg'b'?$efficiency: <br /> )(AAA, 7/31/2017 <br /> Office of the County Attorney EAA3D33ED8A8465... Date: <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@orangecountync.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 2/17 5 <br /> r CDS <br /> s <br />