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Revised 11/19 <br />8 <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br />Party/Vendor Name: Innovation Associates Organizational Learning Party/Vendor Contact Person: Michael <br />Goodman Contact Phone: Party/Vendor Address: 131 Court St, Unit #14 City Exeter State: NH Zip: <br />03833 Department: BOCC Amount: $5, 000+ travel expenses Purpose: BOCC retreat Budget Code(s): 10200020- <br />630000 /10200020-720019 (if needed) Vendor # 65903 (N/A if new vendor) Vendor is a BOCC consultant? <br />Yes No Contract Type: (Check one) New Renewal Amendment Effective Date 1/24/2020 <br />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 /> <br />Department Director’s Signature ________________________________________ 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 sufficiency of insurance standards, specifications, and requirements: <br />Office of the Risk Management Officer___________________________________ 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: <br />Office of the Chief Financial Officer ____________________________________ Date: _________ <br />Legal Services <br />This agreement is approved as to legal form and sufficiency: <br />Office of the County Attorney __________________________________________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 />DocuSign Envelope ID: 7AC19822-A03D-41B1-81B7-A4F00F954ABA <br /> <br /> <br /> <br />