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DocuSign Envelope ID:20118219-A7E9-41F1-A36D-44700C004BFC <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Chapel Hill Carrboro City SchoolsParty/Vendor Contact Person: Jessica O'Donovan Contact <br /> Phone: 919-967-8211 x28225 Party/Vendor Address: 750 S. Merritt Mill Road City Chapel Hill State: NC Zip: <br /> 27516 Department: Health Amount:J62 388 Purpose: FPG Enrichment Camn Budget Code(s): 10412020-630000- <br /> 71453Vendor#22226 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No ® Contract Type: (Check <br /> one)New ❑ Renewal X Amendment ❑ Effective Date 5-1-19 Approved by Board Yes❑ No❑ Agenda <br /> 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 /> DocuSigned by: <br /> S�_Wof 4/10/2019 <br /> Department Director's Signature aCisF2DosEsaa5F" 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 <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 sufficient Wocusigned by: rds,specifications,and requirements: <br /> �,bVln.t,{�6 4/10/2019 <br /> Office of the Risk Management Officer 7��$�.FDCF91768004M" Date: <br /> Financial Services <br /> This instrument has been pre-audited i Docusigned by: the Local Government Budget and Fiscal Control Act: <br /> 4 4/15/2019 <br /> Office of the Chief Financial Officer 704E51S1ACC1409" Date: <br /> Legal Services <br /> This agreement is approved as tc11" <br /> " Doeusigned by: <br /> J, f.a.Y'f, �$cb 4/15/2019 <br /> Office of the County Attorney Date: <br /> 079A4D525C0F4FB. <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 /> Page 7 of 6 <br /> Revised 212019 <br />