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Revised 2/17 <br />ORANGE COUNTY---DEPARTMENT USE ONLY---HARD COPY ONLY <br />______________________________________________________________________________ <br />Department <br /> <br />Party/Vendor Name: John Loftin, Attorney Party/Vendor Contact Person: John Loftin Contact Phone: 919 732 <br />9748 Party/Vendor Address: 117 North Churton St, City Hillsborough State: NC Zip: 27278 Department: CSS <br />Amount: <5K/$100hr Purpose: representation when primary & secondary attorneys are conflicted Budget <br />Code(s): 10 44002063400 Vendor # 50928 (N/A if new vendor) Vendor is a BOCC consultant? Yes No <br />Contract Type: (Check one) New Renewal xx Amendment Effective Date 07/01/2018 Approved by <br />Board Yes No Agenda Date: <br /> <br />This agreement is approved as to technical form and content: <br /> <br />Department Director’s Signature ________________________________________ Date: ________ <br /> <br /> <br />Information Technologies <br /> <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 specificatio ns: <br /> <br />Office of the Chief Information Officer___________________________________ Date: ________ <br /> <br /> <br />Risk Management <br /> <br />This agreement is approved for sufficiency of insurance standards, specifications, and requirements: <br /> <br />Office of Risk Management_____________________________________________ Date: _________ <br /> <br /> <br />Financial Services <br /> <br />This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br />Act: <br /> <br />Office of the Chief Financial Officer ____________________________________ Date: _________ <br /> <br /> <br />Legal Services <br /> <br />This agreement is approved as to legal form and sufficiency: <br /> <br />Office of the County Attorney __________________________________________Date: ________ <br /> <br /> <br />Clerk to the Board <br /> <br />Received for record retention: <br /> <br />Office of the Clerk to the Board __________________________________________Date:_________ <br />DocuSign Envelope ID: 031C1542-3624-44B6-881F-E9241F62B051 <br />7/3/2018 <br />7/3/2018 <br />7/3/2018 <br />7/3/2018