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DocuSign Envelope ID:2AEBF8B6-5B1F-4667-AEEE-787244DBD7C8 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: YMCA of the Triangle, Inc. Party/Vendor Contact Person: Aubrey Vinson Contact Phone: 919- <br /> 442-9622 Party/Vendor Address: 980 MLK Jr. Blvd City Chapel Hill State: NC Zip: 27514 Department: Health <br /> Amount: $2,500 Purpose: Provide an after school Y Learning_program at New Hope elementar. Budget Code(s): <br /> 10412020-630000-71453 Vendor # 52475 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® <br /> Contract Type: (Check one)New❑ Renewal ® Amendment ❑ Effective Date 1/16/19 Approved by Board Yes <br /> ❑No❑ Agenda Date: <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work on <br /> this project has not been initiated prior to execution of the agreement: <br /> OocuSigned by, <br /> i Aan A S&Wof 1/16/2019 <br /> Department Director's Signature 3C18F2�09E3445F. Date: <br /> Agreements for emergency services or repair are not subject to the above affirmation. If services related to this <br /> agreement have already begun or been completed please briefly describe the nature of the emergency condition that was <br /> addressed: <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- - cii5igned-a,;-`--a-rds, specifications,and requirements: <br /> �U$66 �,DVln.t 6 1/24/2019 <br /> Office of the Risk Management Office Date: <br /> 7F6CF9178800498. <br /> Financial Services <br /> This instrument has been pre-audited it oocusigned by: the Local Government Budget and Fiscal Control Act: <br /> r o 1/24/2019 <br /> Office of the Chief Financial Officer 7NE5181ACC14o9. Date: <br /> Legal Services <br /> This agreement is approved as t ooeusigned by: <br /> �WAk ftA�'it, �S(b 1/24/2019 <br /> Office of the County Attorney Date: <br /> 079A4D525C0F4Fg. <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@orangecountync.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 12/18 4 <br />