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DocuSign Envelope ID:COF94A42-7FOE-4EA7-9BAB-700005351OC3 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Antonio Aguilar Party/Vendor Contact Person: Antonio Aguilar Contact Phone: 336-263-0050 <br /> Party/Vendor Address: 498 Stonewall Drive City Mebane State: NC Zip: 27302 Department: DEAPR-Recreation <br /> Amount: $2,450.00 Purpose: Lacrosse Summer Camps Instruction Budget Code(s): 10511020 630000 Vendor # <br /> 64683 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New <br /> Renewal ❑ Amendment ❑ Effective Date July 15, 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 on <br /> this project has not been initiated prior to execution of the agreement: <br /> ]Docusigned by: <br /> 'Ja�� ����� 6/30/2019 <br /> Department Director's Signature 611cFA1D507A495.. 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---rD-*o-c-uSi9-ned-b-y:-`--'-rds, specifications,and requirements: <br /> �U$66 �,DVln.t 6 6/30/2019 <br /> Office of the Risk Management Office Datc: <br /> 7FDCF9178800498. <br /> Financial Services <br /> This instrument has been pre-audited i Docusigned by: the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Office A . Date:6/30/2019 <br /> 7D4E5181 AM 4M <br /> Legal Services <br /> This agreement is approved as tc Do cusigned by, iciency: <br /> Office of the County Attorney Date:7 1 2019 <br /> EAA3D33ED8AE4S5.. <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 /> Ds <br /> GS <br />