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DocuSign Envelope ID:5587EA2F-757E-4B9C-8358-F67692A600D3 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Dispute Settlement Center Party/Vendor Contact Person: Frances Henderson Contact Phone: <br /> 919-929-8800 Party/Vendor Address: 302 W. Weaver Street City Carrboro State: NC Zip: 27510 Department: <br /> BOCC Amount: $6,000 Purpose: BOCC Retreat facilitation Budget Code(s): 10200020-630000 Vendor# 6127 <br /> (N/A if new vendor) Vendor is a BOCC consultant? Yes ® No❑ Contract Type: (Check one) New <br /> Renewal ❑ Amendment ❑ Effective Date 1/24/2020 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 /> DocuSigned by: <br /> [7E,1,,F,,,7,4,E.. <br /> 61h.1rt.A. �ja.�F..Y' 12/18/2019 <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 -bocuSigned by, is,specifications,and requirements: <br /> 9US66 (,bwt.�t,{�6 12/19/2019 <br /> Office of the Risk Management Officer 7F❑CF9176900498. 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 /> 12/19/2019 <br /> Office of the Chief Financial Officer_ ,❑aEsaa1ACC1409. Date: <br /> Legal Services <br /> This agreement is approved as to UoeuSigned by: ciency: <br /> �6� �k� 12/19/2019 <br /> Office of the County Attorney EAA3D33EDSAW5.. 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 11/19 <br /> 8 <br />