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AS O - 90Y <br /> ORANGE COUNTY---DEPARTMENT USE ONLY---HARD COPY ONLY <br /> Department <br /> Party/Vendor Name: Town of Chapel Hill Party/Vendor Contact Person: Jackie Thompson Contact Phone: <br /> Party/Vendor Address: 405 Martin Luther King Jr Blvd City Chapel Hill State: NC Zip: 27V4 Department: <br /> Aging Amount: $12,300 urpose: Volunteer Connect 55+ Budget Code(s): 10434005-448910 endor#64 (N/A& <br /> if new vendor) Vendor is a BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New❑ Renewal <br /> Amendment ❑ Effective Date 07/01/2017 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 /> Office of Risk Management / �,�-- (�% 2 � Date: 7 <br /> Financ' 1 Services <br /> This instrument has been pre-audited in the in er q ired by the Local Government Budget and Fiscal Control <br /> Act: <br /> Office of the Chief Financial Officer Date: ? 17 ,7 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> Office of the County Attorney j�,4,/ � /`6. 1���' Date: 1 ►-1 11 <br /> Clerk to the Board <br /> Received for record retention: <br /> Office of the Clerk to the Board Date: <br /> Revised 2/17 <br />