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DocuSign Envelope ID: B62ADD07-054A-4EAE-9F8A-lC671D8F3743 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Valerie Roberts Party/Vendor Contact Person: Contact Phone: Party/Vendor <br /> Address: 1501 Kirkwood Drive City Durham State: NC Zip: 27705 Department: Aging Amount: 1000 Purpose: <br /> Senior Center Instructor Budget Code(s): 10430120-629000 Vendor # 61484 (N/A if new vendor) Vendor is a <br /> BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New® Renewal ❑ Amendment ❑ Effective Date <br /> 03/10/2020 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 /> D <br /> DocuSigned by: <br /> t '�� 3/5/2020 <br /> Department Director's Signature 67 Date: <br /> E962D16F454FA... <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 a66 L.Qw 6_ Date:3/6/2020 <br /> 7FDCF9176800408... <br /> Financial Services <br /> This instrument has been pre-audited in ' Docusigned by: ' '' he Local Government Budget and Fiscal Control Act: <br /> 1r1)'N4 � 3/10/2020 <br /> Office of the Chief Financial Officer Date:- 704E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to DocuSigned by: icy: <br /> Office of the County Attorney ' ' - Date: 3/10/2020 <br /> 4035C68304CA4M... <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 />