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DocuSign Envelope ID:98441AC0-98B7-459F-80FE-32FEA12F44D6 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Ruth Merrick Party/Vendor Contact Person: Contact Phone: Party/Vendor <br /> Address: 215 S Hillsborough Ave City Hillsborough State: NC Zip: 27278 Department: Aging Amount: $3,000 <br /> Purpose: classes Budget Code(s): 10430120-629000 Vendor# 58822 (N/A if new vendor) Vendor is a BOCC <br /> consultant? Yes ❑ No® Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ Effective Date <br /> 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 /> Wcusigned by: <br /> Department Director's Signature � t Date: 2/20/2019 <br /> Agreements for emergency services or__r B7Egsz❑1BF454FAJ. -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 /> Wcu5igneed_by, <br /> . <br /> Office of the Risk Management Officer 9US66 `r'6 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 /> Docu5igned by: <br /> Office of the Chief Financial Officer 4 . Date: 2/22/2019 <br /> 704E51S1ACC1409. <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> ocuSigned by: <br /> Office of the County AttorneyC_� <br /> �.�.{,t�, �,�_ Date:4/8/2019 <br /> 035CB8304CA4M <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 />