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DocuSign Envelope ID:2602A108-A665-43B3-826A-26E7C4856C80 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Luna Lee Ray Party/Vendor Contact Person: Contact Phone: Party/Vendor <br /> Address: PO Box 1372 City Carrboro State: NC Zip: 27510 Department: Aging Amount: $4,800 Purpose: Senior <br /> Center Instructor Budget Code(s): 10430120-629000 Vendor # 48614 (N/A if n new vendor) Vendor is a BOCC <br /> consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ Effective Date <br /> 07/01/2019 Approved by Board Yes❑Nor-1 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 J U_ fi ltr Date: 7/28/2019 <br /> Agreements for emergency services W@2atWMf,%ubject 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 sufficiency of insurance standards, specifications,and requirements: <br /> DocuSigned by: <br /> Office of the Risk Management OfficerQ�tSa nt. 0 Date: 7/29/2019 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> gned by: <br /> Office of the Chief Financial Officer DocuSi Date: 7/29/2019 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: <br /> Office of the County Attorney Date:7/29/2019 <br /> 4035CB8304CA4A9... <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 />