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DocuSign Envelope ID: F65EOD95-4748-43OB-B7D4-57947C3D102E <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Racial Equity Institute, LLC Party/Vendor Contact Person: Megan Hayes-Bell Contact <br /> Phone: 336-362-3533 Party/Vendor Address: 454 Gorrell St. City Greensboro State:NC Zip: 27406 Department: <br /> Health Amount: $5,500 Purpose: Racial Equity Groundwater Presentation Budget Code(s): 10412020-630000- <br /> 71460 Vendor#N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check <br /> one) New ® Renewal ❑ Amendment ❑ Effective Date 10-9-19 Approved by Board Yes[—] No[—] <br /> 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 /> S&Wo- 10/2/2019 <br /> Department Director's Signature_ sCisF20osEsa45F. 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 <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 sufficient �ocusigned by: rds,specifications,and requirements: <br /> aUS& �,bV1n.A6 10/2/2019 <br /> Office of the Risk Management Office El <br /> . 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 /> A " 10/7/2019 <br /> Office of the Chief Financial Officer 7oaE5aa1ACC1409. Date: <br /> Legal Services <br /> d by:e <br /> This agreement is approved as t OocuSign .{� <br /> 9WAk f, l�5� 10/7/2019 <br /> Office of the County Attorney 079A4D525C0F4FB. 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 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 />