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DocuSign Envelope ID:A69442DO-BODB-4408-99AF-E63626C62761 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Dispute Settlement Center Party/Vendor Contact Person: Frances Henderson Contact Phone: <br /> 919-929-8800 ext. 11 Party/Vendor Address: 302 West Weaver Street #A City Carrboro State: NC Zip: 27510 <br /> Department: Finance and Administrative Services Amount: $6,500 Purpose: Collaboration Facilitation Services <br /> Budget Code(s): 10395020-720152 Vendor#6127 (N/A if new vendor) Vendor is a BOCC consultant? Yes <br /> No❑ Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date 7/1/2019 Approved by <br /> Board Yes®No❑ Agenda Date: 6/18/2019 <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 /> DocuSigned by: <br /> 61ti.lrt.a 54ty 8/7/2019 <br /> Department Director's Signature Date: <br /> 1V7E61B3FC08734DE. <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: N/A <br /> Risk Management <br /> This agreement is approved for sufficiency of insw17FDCF0176800408 <br /> Docusigned by: fications,and requirements: <br /> &A c6m&6 8/7/2019 <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 /> 17NE5181ACC1409 <br /> q '� . 8/7/2019 <br /> Office of the Chief Financial Officer . Date: <br /> Legal Services <br /> This agreement is approved as to legal form an DocuSigned by: <br /> �6Ll.W K6�C`,fs 8/7/2019 <br /> Office of the County Attorney EA43D33ED8AW5.. Date: <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 copie11)7E61B3FC08734DE.. <br /> oocuSigned by: red for Docusign contracts: <br /> 6ln.. A 1J4L' 8/7/2019 <br /> Office of the Clerk to the Board Date: <br /> Revised 12/18 <br /> 8 <br />