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DocuSign Envelope ID:00A76B12-2D1 E-4D50-98BA-D2B501 C3044E <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: CHICLE Language Institute Party/Vendor Contact Person: Perla Saitz Contact Phone:919-933- <br /> 0398 Party/Vendor Address: 109 Conner Dr., Ste 2200 City Chapel Hill State: NC Zip: 27514 Department: Aging <br /> Amount: $14,950 Purpose:class instructors Budget Code(s): 10430120-629000 Vendor#43840 (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ <br /> Effective Date 9/01/17 Approved by Board Yes III No Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> DocuSigned by: <br /> fi turDepartment Director's Signature lo- y Date: 9/26/2017 <br /> B7E962D1 BF454FA... <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 /> DocuSigned""by: <br /> ''111L <br /> Office of the Risk Management Officer aLlSa �,bvvutt0 Date: 9/27/2017 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the DocuSigned manner by:required by the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial OffiL cer q ' °' '12°'L Date:Aate: 9/27/2017 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal oru Igoe r1 a y:sfficiency: <br /> oc <br /> Office of the County Attorney ✓ -( „ Date: 9/28/2017 <br /> 4035CB8304CA4A9... <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 />