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DocuSign Envelope ID:603A1B64-AD7D-4383-A675-7123B19BOFBF <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: LGBTO Center of Durham Party/Vendor Contact Person: Helena CraQQ <br /> <hcra,aa((d,labtgcenterofdurham.org> Contact Phone: 919-827-1436 Party/Vendor Address: 114 Hunt Street <br /> City Durham State:NC Zip:27701 Department: County Manager-Homeless Programs Amount: $1000.00 Purpose: <br /> Training Budget Code(s): 32470620 680021 Vendor#N/A (N/A if new vendor) Vendor is a BOCC consultant? <br /> Yes ❑ No® Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date 5/28/19 Approved <br /> 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 on <br /> this project has not been initiated prior to execution of the agreement: <br /> .DocuSigned by: <br /> Department Director's Signature lS Date: 6/12/2019 <br /> Agreements for emergency services or repair are ME81a128364M - ✓e 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 sufficiency of insurance standards,specifications,and requirements: <br /> DocuSigned by: <br /> Office of the Risk Management Officer US& CO A6 Date: 6/2 5/2019 <br /> 7FDCF91769004M- <br /> Financial Services <br /> This instrument has been pre-audited in the manner reauired by the Local Government Budget and Fiscal Control Act: <br /> DocuSigned by: <br /> Office of the Chief Financial Officer � 41.441 Date: <br /> 6/25/2019 <br /> 7NE5181ACC14N- <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: <br /> Office of the County Attorney , 6LW K6�C ,fs Date:6/28/2019 <br /> EAMD33EMAW5-- <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 />