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Revised 10/17 <br />8 <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br />Department <br /> <br />Party/Vendor Name: YMCA of the Triangle, Inc. Party/Vendor Contact Person: Aubrey Vinson Contact Phone: <br />919-442-9622 Party/Vendor Address: 980 MLK Jr. Blvd City Chapel Hill State: NC Zip: 27514 Department: <br />Health Amount: $2,500 Purpose: Provide an after school Y Learning program at New Hope elementary. Budget <br />Code(s): 10412020-630000-71453 Vendor # 52475 (N/A if new vendor) Vendor is a BOCC consultant? Yes <br />No Contract Type: (Check one) New Renewal Amendment Effective Date 9/1/17 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 Donna Lloyd upon completion @ Dolloyd@orangecountync.gov <br /> <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 />DocuSign Envelope ID: 2D232CEA-B53A-4F88-8254-9E5614B35A63 <br />1/3/2018 <br />1/5/2018 <br />1/5/2018 <br />1/5/2018