Orange County NC Website
DocuSign Envelope ID: F13782C7-F41B-4D80-BE03-06F8COB4B268 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Ruth Merrick Party/Vendor Contact Person: Contact Phone: Party/Vendor <br /> Address: 215 S Hillsborough Ave City Hillsborough State: NC Zip: 27278 Department: Aging Amount: $7,800 <br /> Purpose: Senior Center Instructor Budget Code(s): 10430120-629000 Vendor # 58822 (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New ❑ Renewal ® Amendment ❑ <br /> Effective Date 07/01/2019 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 /> DocuSigned by: <br /> Department Director's Signature 5Adn,lU_ fi ltr Date:8/23/2019 <br /> Agreements for emergency services aivmieFutrsubject 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 /> DocuSigned by: <br /> Office of the Risk Management Officer riusa, r,OVLt.t . Date:8/23/2019 <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 1_f7D4E5181ACC1409 <br /> Date: 8/26/2019 <br /> ... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: <br /> Office of the County Attorney Date:8/27/2019 <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 <br /> 8 <br />