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Revised 10/17 <br />ORANGE COUNTY---DEPARTMENT USE ONLY---HARD COPY ONLY <br />______________________________________________________________________________ <br />Department <br />Party/Vendor Name: Winrock International Institute Party/Vendor Contact Person: William Gray Contact <br />Phone: 703-302-6612Party/Vendor Address: 2121 Crystal Dr., Ste 500City Arlington State: VAZip: 23225 <br />Department: Economic DevelopmentAmount: -15,000Purpose: FellowshipBudget Code(s): NAVendor # NA <br />(N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New <br />Renewal Amendment Effective Date Approved by Board Yes No Agenda Date: <br />This agreementis 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 hasbeen 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_____________________________________________ Date: _________ <br />Financial Services <br />This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br />Act: <br />Office of the Chief Financial Officer ____________________________________ Date: _________ <br />Legal Services <br />This agreement is approved as to legal form and sufficiency: <br />Office of the County Attorney __________________________________________Date: ________ <br />Clerk to the Board <br />Received for record retention: <br />Office of the Clerk to the Board __________________________________________Date:_________ <br />DocuSign Envelope ID: DFF724E2-6327-4662-AC33-2349BDDD2704 <br /> <br /> <br /> <br />