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DocuSign Envelope ID:2ED162C9-56B4-4E3B-B5E1-D362BBB00188 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Chapel Hill Carrboro County Schools Party/Vendor Contact Person: Charlos Banks Contact <br /> Phone: 919-967-8211 x28244 Party/Vendor Address: 750 S. Merritt Mill Road City Chapel Hill State: NC Zip: <br /> 27516 Department: Health Amount: $2,500 Purpose: After school programming at Carboro Elementar. Budget <br /> Code(s): 10412020-630000-71453 Vendor#22226 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No <br /> ® Contract Type: (Check one)New ❑ Renewal ® Amendment ❑ Effective Date 10/15/18 Approved by Board <br /> Yes❑No❑ Agenda Date: <br /> This agreement is approved as to to Docusigned by: <br /> 6WKjia' S&WAk 1/3/2019 <br /> Department Director's Signature 3c16F2D09E3445F. 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 sufficienc DocuSigned by: rds,specifications,and requirements: <br /> QUS66 �,bVln.f,{�6 1/3/2019 <br /> Office of the Risk Management Office 7F❑cFe176900498. Date: <br /> Financial Services <br /> This instrument has been pre-audited it Docusigned by: the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer LI-N 4 Date:1/3/2019 <br /> NE5181ACC1400- <br /> Legal Services <br /> This agreement is approved as t DocuSigned by: <br /> ��x- �t, T 6S(h 1/3/2019 <br /> Office of the County Attorney 079A4D525c0F4FB. Date: <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion: sin erp sollkoran_ep countync.gov <br /> The following signature block is for hard copies only and is not required for Docusign contracts: <br /> Office of the Clerk to the Board Date: <br /> Revised 10/17(Mgr appry 5k 6/18) 4 <br />