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DocuSign Envelope ID: F1823DA5-CEA2-4E80-9B30-63B814426F6D <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Michael Newton Party/Vendor Contact Person: Contact Phone: Party/Vendor <br /> Address: 700 Williams Cirrcle City Chapel Hill State:NC Zip: 27516 Department: Aging Amount: 2000 Purpose: <br /> Senior Center Instructor Budget Code(s): 10430120-629000 Vendor # 66009 (N/A if new vendor) Vendor is a <br /> BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New® Renewal ❑ Amendment ❑ Effective Date <br /> 03/01/2020 Approved by Board Yes❑Nor-1 Agenda Date: <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work on <br /> this project has not been initiated prior to execution of the agreement: <br /> DocuSigned by: <br /> Department Director's Signature t '�� Date: 3/2/2020 <br /> D <br /> 67E962M BF454FA... <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 was <br /> 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 sufficienc oocu's;9nea by:`"-1--ds, specifications,and requirements: <br /> Office of the Risk Management Officer �66 L,DWt. 6_ Date: 3/2/2020 <br /> 7FDCF9176800408... <br /> Financial Services <br /> This instrument has been pre-audited iiIr7NE5181AMA00 <br /> ' oocusigned by: the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer 4 � Date: 3/3/2020 <br /> . <br /> Legal Services <br /> This agreement is approved as tc DocuSigned by: ney: <br /> Office of the County Attorney35C68304,'A4A�...`- Date: 3/4/2020 <br /> 40 <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 4 <br />