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r) <br /> ,,_, / q <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: 40 Martin Luther King Jr. Blvd. City Chapel Hill State: NC Zip: 27514 De�partment: <br /> Aging Agipg Amount: 6 00 urpose: Senior Lunch Program Budget Code(s): 10430105-449000-710864endor# 64 <br /> (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New <br /> Renewal ® 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 Do�!� Date: <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 (i �� Date: 7 / 7 l 7 <br /> Fina ial Services <br /> This instrument has been pre-audited in the anne r uired by the Local Government Budget and Fiscal Control <br /> 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 1AM CA,{,t ry* Date: '1 l 1 <br /> ClerILlo tJae Board <br /> Received for record retention: <br /> Office of the Clerk to the Board Date: <br /> Revised 2/17 <br />