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DocuSign Envelope ID: E537A657-6166-4CCF-AE3C-F69678242FF7 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: CHICLE Language Institute Party/Vendor Contact Person: Perla Saitz Contact Phone: <br /> Party/Vendor Address: 109 Conner Dr.,#2200 City Chapel Hill State:NC Zip: 27514 Department: Aging <br /> Amount: $15,000 Purpose: class instructors Budget Code(s): 10430120-629000 Vendor # 43840 (N/A if new <br /> vendor) Vendor is a BOCC consultant? Yes ❑ No[] Contract Type: (Check one) New ❑ Renewal <br /> Amendment ❑ Effective Date 7/01/19 Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is approved as to tecl , DocuSigned by: !nt: <br /> 1 bw 7/26/2019 <br /> Department Director's Signature_ Date: <br /> 67E962D16F454=A.. <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 0­ DocuSigned ay: ' specifications,and requirements: <br /> [7FDCF917e800498_ <br /> usx cbVl�t.f,{�6 7/29/2019 <br /> Office of the Risk Management Officer Date: <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: DocuSigned by: <br /> A.&I. 8/1/2019 <br /> Office of the Chief Financial Officer ` o4E51a1ACC1409. Date: <br /> Legal Services <br /> This agreement is approved as to It DocuSigned"ay: y: <br /> Office of the County Attorney ` '°} - Date: 8/1/2019 <br /> 4035C68304CA4M <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion: sin erg solIkoran eg countync•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 10/17 <br /> 8 <br />