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DocuSign Envelope ID:04427790-FOA9-465F-A8FA-F93F2F47785C <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Elena Marinina Party/Vendor Contact Person: Elena Marinina Contact Phone: 919.943.6451 <br /> Party/Vendor Address: 3213 Anandale Rd. City Durham State: NC Zip: 27705 Department: DEAPR-Recreation <br /> Amount: $1,000.00 Purpose: Piano Instruction Budget Code(s): 10511020 630000 Vendor # 61078 (N/A if new <br /> vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ <br /> Amendment ❑ Effective Date Sept. 9,2019 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 on <br /> this project has not been initiated prior to execution of the agreement: <br /> DocuSigned by: <br /> awl gawa 8/28/2019 <br /> Department Director's Signature 611CFA1D507A405.. 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 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 sufficient, -Qocusigned by: ds, specifications,and requirements: <br /> QuSa L.Qw�f�b 8/28/2019 <br /> Office of the Risk Management Officer_ 7FDCFe17Es0o4s8. Date: <br /> Financial Services <br /> This instrument has been pre-audited i DocuSigned by: the Local Government Budget and Fiscal Control Act: <br /> 0 8/30/2019 <br /> Office of the Chief Financial Officer[7D4E5aa1ACC14.. Date: <br /> Legal Services <br /> This agreement is approved as tcDEAA,D,,ED.A.,_ <br /> DocuSigned by: iclency: <br /> 61L t. P Y s 9/3/2019 <br /> Office of the County Attorney Date: <br /> . <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 /> P Ds <br /> CS <br />