Orange County NC Website
Browse       Search
ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name : Joan Cecil Party/Vendor Contact Person : Contact Phone : Party/Vendor Address : <br /> 4211 Slim Elmore Ln City Efland State : NC Zip : 27243 Department : A in Amount: $ 4 , 000 Purpose : Senior <br /> Center Instructor Budget Code(s) : 10430120 - 629000 Vendor # 63317 (N/A if 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 ❑ Non 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 /> Department Director ' s Signature Date : ^ � � <br /> Agreements for emergency services o �ie it are not subject to e 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 hardi-vare/sofhvare 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 /> 113111 .Office of the Risk Management Officer Date : <br /> Fi ci Services <br /> This instrument has been pre - audited in the nner e ' d by the Local Government Budget and Fiscal Control Act : <br /> Office of the Chief Financial Officer . Date : f / <br /> LeV,al Services <br /> This agreement is approved as to legal nd sufficiency : <br /> Office of the County Attorney Date : �(1 <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 : /� d <br /> -0 <br /> Revised 12/ 18 4 <br />