Orange County NC Website
DocuSign Envelope ID:280C3E42-170E-4BEF-AB33-D865C5B92DA2 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Russell Knopp Party/Vendor Contact Person: Contact Phone: Party/Vendor <br /> Address: 1021 Alexander Stewart Dr City Hillsborough State: NC Zip: 27278 Department: Aging Amount: <br /> 3 000 Purpose: classes Budget Code(s): 10430120-629000 Vendor#44521 (N/A if new vendor) Vendor is a <br /> BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ❑ Amendment ❑ Effective <br /> Date March 1,2019 Approved by Board Yes[]No❑ Agenda Date: <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work <br /> on this project has not been initiated prior to execution of the agreement: <br /> DocuSigned by:: '_ <br /> Department Director's Signature �Aan.[Gt, +�tt,Y' Date: 2/20/2019 <br /> Agreements for emergency services or - B7E962D1BF454FA.. t 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 <br /> was 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 sufficiency of insurance standards,specifications,and requirements: <br /> DocuSigned by: <br /> Office of the Risk Management Officer QU56 (h4 6 Date:2/20/2019 <br /> 7FDCF9176900498. <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: <br /> DocuSigned by: <br /> Office of the Chief Financial Officer (' A.&I. Date: 2/22/2019 <br /> 704E51S1ACC1409. <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: <br /> Office of the County Attorney 4"" Date.2/22/2019 <br /> 4035CB8304CA4M <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 <br /> 8 <br />