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DocuSign Envelope ID:CEDF6D21-CDDF-48F6-A737-DA2305C80744 <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 Loon City Chapel Hill State: NC Zip: 27516 Department: Manager <br /> Amount: $6,150 Purpose:Racial Equity gram Assessment Budget Code(s): 10213020 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 2/21/20 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 /> Department Director's Signature l vGW�IS �V�C In. Date: 2/25/2020 <br /> Agreements for emergency services or repair are OA3Es1a12s364a4... ve 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 /> DocuSigned by: <br /> Office of the Risk Management Officer aUSA cDWt.t& Date:2/27/2020 <br /> 7FDCF9176900498... <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 Officer s�gx.w�va Date:2/27/2020 <br /> 7D4E59S1ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DlocuSigned by: <br /> Office of the County Attorney , 6lL , K6 u,6 Date:2/28/2020 <br /> E1+A=ED8A8435... <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 /> 9 <br />