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(Ligo Dojo of Budo Karate) <br />Orange County Outside Agency Performance Agreement Page 6 of 7 <br />Rev. 6/15 <br /> <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br />Department <br /> <br />Party/Vendor Name: Ligo Dojo of Budo Karate Party/Vendor Contact Person: Nathan Ligo Contact Phone: 919923- <br />6915 Party/Vendor Address: 2518 Millwood Court City Chapel Hill State: NC Zip: 27514 Department: Finance & <br />Adm. Srv. Amount:$ 2,000 Purpose: Outside Agency Performance Agreement Budget Code(s): 10495050 719068 <br />Vendor # 60958 (N/A if new vendor) Vendor is a BOCC consultant? Yes NoX Contract Type: (Check one) <br />New Renewal Amendment Effective Date July 1, 2015 Approved by Board YesX No Agenda <br />Date: June 16, 2015 <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 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 />DocuSign Envelope ID: 43E9B846-09E2-4994-94AC-B09174436B31 <br /> <br /> <br /> <br />