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320 ��- 53 <br /> 3 <br /> ORANGE COUNTY---DEPARTMENT USE ONLY---HARD COPY ONLY <br /> — — Department--- — ---- --— <br /> Party/Vendor Name: Town of Chapel Hill Party/Vendor Contact Person: Jackie Thompson Contact Phone: <br /> Party/Vendor Address: 405 Mai-tin Luther King Jr. Blvd City Chapel Hill State: NC Zip: 275X4 Department- <br /> Agin Amount: $12,300 Purpose: Volunteer Connect 55+ Budget Code(s): 10434005-448910 Vendor#64 (N/ <br /> c if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: Check one NK 0 Renewal 11� <br /> Amendment ❑ Effective Date 07/01/2018 Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is 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 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 sufficiency of insurance standards,specifications,and requirements: <br /> Office of Risk Management Date:_ [7 <br /> Financial Services <br /> This instrument has been pre-audited in the Oann e aired by the Local Government Budget and Fiscal Control <br /> Act: <br /> Office of the Chief Financial Officer Date: f 1 4 <br /> Leal Services <br /> This agreement is approved as to legal or and sufficiency: <br /> Office of the County Attorney Date: l IV2 <br /> Clerk to the Board <br /> Received for record retention: <br /> Office of the Clerk to the Board Date: <br /> Revised 10/17 <br />