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ORANGE COUNTY---DEPARTMENT USE ONLY---HARD COPY ONLY <br /> Department <br /> Party/Vendor Name: University of North Carolina at Chapel Hill Party/Vendor Contact Person: Kevin Castle <br /> Contact Phone: Party/Vendor Address: 3114 Bondurant Hall, CB#7120 City Chapel Hill State: NC Zip: <br /> 27599 Department: Aging Amount: $90,000 Purpose: OC CARES Budget Code(s): 30432005-444140-71092 <br /> Vendor# 10419 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No❑ Contract Type: (Check one)k, i I��'1 <br /> New ❑ Renewal ® Amendment El Effective Date 9/01/17 Approved by Board Yes❑ No❑ Agenda <br /> 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 ��^— 1.JJ � '—' Date: 21Fz t;--/( '7 <br /> Financial Services <br /> This instrument has been pre-audited in the ner r it d by e Local Government Budget and Fiscal Control <br /> Act: <br /> Office of the Chief Financial Officer Date: 2f <br /> 7 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> Office of the County Attorney Aut L"' � d�," Date: <br /> Clerk to the Board <br /> Received for record retention: <br /> Office of the Clerk to the Board Date: <br /> Revised 2/17 <br />