R 2017-512-E Aging - Benjamin Rosado - MAP intern

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DocuSign Envelope ID:30AA40B6-A75F-4D67-935B-7965AF21 ECE5 ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Benjamin Rosado Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: 105 A/B W Can Street City Carrboro State: NC Zip: 27510 Department: Aging Amount: $2,000 Purpose: MAP Intern Budget Code(s): 10430020-630120 Vendor # 64708 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date 8/20/17 Approved by Board Yes' No Agenda Date: This agreement is approved as to technical form and content: /^--DocuSigned by: Department Director's Signature J 1GL pttA,V' Date: 9/13/2017 B7E962D1BF454FA... Information Technologies (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer Date: Risk Management This agreement is approved for sufficiency of insurance standards,specifications,and requirements: r---DocuSigned by: Office of the Risk Management Officer MS& CbYliuth Date: 9/14/2017 7FDCF9176800498... Financial Services This instrument has been pre-audited in the rreouired by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer 9/14/2017 �aN ona,�/am —7D4E5181 ACC1409... Legal Services This agreement is approved as to l i for�tn and sufficiency: ocu igne y: a,AAAA. hark, -Nto 9/14/2017 Office of the County Attorney Date: 079A4D525C0F4FB... Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd @orangecountync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board Date: Revised 2/17 5