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CZolg - 5�5� <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> PartyNendor Name: Puuuseria Dona Ixura Party/Vendor Contact Person: Iosefina Salazar Zeoeda Contact <br /> Phone: Party/Vendor Address: 813 Carter Avenue City Durham State: NC Zip: 27703 Department: <br /> County Manager Amount: LO Purpose: Food Vendor Budget Code(s): 34600020 900057 Vendor M 65328 (N/A <br /> if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ <br /> Amendment ❑ Effective Date Approved by Board Yes❑ Np❑ Agenda Date: <br /> This agreement is approved as to technical form and content: j <br /> Department Director's Signature�/— Date: �/0 <br /> Information Technologies <br /> (Applicable only to hardware/soJhvare 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 the Risk Management Officer Date: —r-%'-F�s' <br /> jfinancialffiel2rices <br /> This instrument has been pre-audited in the at by the Local Government Budget and Fiscal Control <br /> Act: <br /> Office of the Chief Financial Officer Date: ap <br /> Legal Services <br /> This agreement is approved as to legal form and suffi ie y: <br /> Office of the County Attorney Date: �U <br /> Jerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sheri Ingersoll upon completion: simsmi llRoraneecounNnc.gov <br /> The following signature block is for hard copies only and is not required for Docusign contacts: <br /> Office of the Clerk to the Board Date: <br /> LF2018 v.1. <br /> 7 <br />