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DocuSign Envelope ID: E582D2EC-BBB8-4953-BOOC-76359B4F8551 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Tina Vasquez Party/Vendor Contact Person: Tina Vasquez Contact Phone: 845-300-6274 <br /> Party/Vendor Address: 6418 Gold Mine Loop City Chapel Hill State: NC Zip: 27516 Department: Manager <br /> Amount: $10,000 Purpose: Racial Disparity Assessment Budget Code(s): 32470620 630000 Vendor # 65193 <br /> (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New <br /> Renewal❑ Amendment ❑ Effective Date 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 /> 1-50 <br /> cuSigned by: <br /> Department Director's Signature S kJVUA, Date 9/30/2019 <br /> Agreements for emergency services or repair are not 'outlaBtlwe&bove 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 /> 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 9USI, l pp o o Date:10/1/2019 <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 OfficerF� +� Date: 10/1/2019 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> igned by:,�, <br /> Office of the County Attorney 56Z, r4�u'T' Date:10/1/2019 <br /> EAA3D33FD8A8465... <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 />