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DocuSign Envelope ID: 7E4F17AD-3D24-4CFD-B460-2016824BE3E0 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Valerie Roberts Party/Vendor Contact Person: Contact Phone: Party/Vendor <br /> Address: 1501 Kirkwood Drive City Durham State: NC Zip: 27705 Department: Aging Amount: $3.000 Purpose: <br /> Class Instructor Budget Code(s): 10430120-629000 Vendor # 61484 (N/A if new vendor) Vendor is a BOCC <br /> consultant? Yes ❑ No Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ Effective Date <br /> 10/01/17 Approved by Board Yes No Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> DocuSigned by: <br /> Department Director's Signature iatn,o- fii Date: 10/24/2017 <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 /> ''1L <br /> Qtis& (,6vvte tt0 10/25/2017 <br /> Office of the Risk Management Office Date: <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> DocuSigned by: <br /> Office of the Chief Financial Officer (21,61 0 .i. Date: 10/25/2017 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency:ign <br /> Office of the County Attorney 10/25/2017 <br /> y y �; � Date: <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 />