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DocuSign Envelope ID: F4803753 -24A8- 4733- 80BB- 2D1917D1DOF5 <br />ORANGE COUNTY — DEPARTMENT USE ONLY <br />Department <br />Party/Vendor Name: Jason Zwilling Party/Vendor Contact Person: Jason Zwilling Contact Phone: (917) 790 -9685 <br />Party/Vendor Address: 2406 Uphill Court City Hillsborough State: NC Zip: 27278 Department: DEAPR- Recreation <br />Amount: $945.00 Purpose: Capoeira Instruction Budget Code(s): 10511020 630000 Vendor # 64346 (N /A if new <br />vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ <br />Amendment ❑ Effective Date Aug. 29, 2018 Approved by Board Yes❑ No® Agenda Date: <br />This agreement is approved as to to [Fuj"d DocuSigned by: 7nt: <br />g.,a 8/24/2018 <br />Department Director's Signature <br />6i Date: <br />1CFA16507A495... <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 sufficienc' DocuSigned by: <br />,USX Cb�6 <br />Office of the Risk Management Officer_ 7FDCF9176800498... <br />•ds, specifications, and requirements: <br />Financial Services <br />This instrument has been pre- audited in DocuSigned by: <br />Office of the Chief Financial Officer <br />7NE5181ACCAG9... <br />This agreement is approved as t DocuSigned by: <br />Office of the County Attorney EAOMaEMAW5... <br />Date: 8/25/2018 <br />the Local Government Budget and Fiscal Control Act: <br />Legal Services <br />iciency: <br />Clerk to the Board <br />8/27/2018 <br />Date: <br />Date: 8/27/2018 <br />Received for record retention: <br />All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersollgorangecountwgov <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 10/17 (Mgr appry 5k 6/18) <br />2 <br />DS <br />D <br />