Orange County NC Website
Browse       Search
Revised 10/17 <br />8 <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br />Department <br /> <br />Party/Vendor Name: Play-WellTEKnologies Party/Vendor Contact Person: Paul Deans Contact Phone: <br />206.484.1043 Party/Vendor Address: 224 Greenfield Ave. Ste. B City San Anselmo State: CA Zip: 94960 <br />Department: DEAPR-Recreation Amount: $4,800 Purpose: STEM Fundamentals Summer Camps Instruction <br />Budget Code(s): 15011020 630000 Vendor # 63101 (N/A if new vendor) Vendor is a BOCC consultant? Yes <br /> No Contract Type: (Check one) New Renewal Amendment Effective Date 7/9/18 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 specifications: <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 the Risk Management Officer___________________________________ 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 />All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@orangecountync.gov <br />The following signature block is for hard copies only and is not required for Docusign contracts: <br /> <br />Office of the Clerk to the Board __________________________________________Date:_________ <br /> <br /> <br /> <br />DocuSign Envelope ID: 4B68CDD7-E84E-4D6A-A84C-31426529C84B <br /> <br /> <br /> <br />