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�u I-S <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 Phon <br /> Party/Vendor Address: 405 Martin Luther King Jr. Blvd City Chapel Hill State: NC Zip: 27514 partment: <br /> Aging Amount: $6,500 Purpose: Senior Lunch Program Budget Code(s): 10430105-449000-71086 endor# 64 <br /> (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ <br /> Renewal ® Amendment ❑ Effective Date 07/01/2018 Approved by Board Yes❑ No❑ Agenda Date: (� <br /> q <br /> This agreement is approved as to technical form and content: <br /> Department Director's Signature Date: 9-�' <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 j <br /> Financial Services <br /> This instrument has been pre-audited in the anner d by the Local Government Budget and Fiscal Control <br /> Act: <br /> Office of the Chief financial Officer _ Date: <br /> Leal Services <br /> This agreement is approved as to legal forr d sufficiency: <br /> Office of the County Attorney _ Date: rq <br /> Clerk to the Board <br /> Received for record retention: <br /> Office of the Clerk to the Board Date: <br /> Revised 10/17 <br />