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DocuSign Envelope ID:4409F8C2-BAB8-4DD2-B2F1-FOEE2E1BA2D6 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: UNC Partnerships in Aging Program Party/Vendor Contact Person: Contact Phone: <br /> Party/Vendor Address: City State: Zip: Department: Aging Amount: $5, 000 <br /> Purpose: MAP Implementation on Housing Budget Code(s): 10430020-630120 Vendor # 10419 (N/A if new <br /> vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal <br /> Amendment ❑ Effective Date 7/1/2019 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 /> h DocuSigned by: <br /> J t - � 6/14/2019 <br /> Department Director's Signature g7E962DIBF454FA.. 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 sufficiency of insurance standards,specifications,and requirements: <br /> WcuSiggned_by: <br /> - <br /> Office of the Risk Management Officer Qusa. (h4 6 Date:6/14/2019 <br /> 7FDCF9176800498. <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 4 Date: 6/14/2019 <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 *J0 flnk__ Date: 6/18/2019 <br /> 4035CB8304CA4Ae <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 /> 4 <br />