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DocuSign Envelope ID:01961751-14B1-4AFD-A8E3-C1BDFC2941A3 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Maha Ganapathi, LLC d/b/a The Microtel Inn & Suites Hillsborough Party/Vendor Contact <br /> Person: Natalie Edwards Contact Phone: 919-245-3102 Party/Vendor Address: 120 Old Dogwood Street City <br /> Hillsborough State:NC Zip:27278 Department:Emergency Services Amount: $34,800 Purpose:FEMA Emergency <br /> Non-Congregate Care Sheltering Budget Code(s): 10750020 630000 95020 Vendor# 33329 (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ <br /> Effective Date 04/10/20 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 on <br /> this project has not been initiated prior to execution of the agreement: <br /> UoeuSigned by: <br /> Department Director's Signature w,IA, Y&u Date: 4/15/2020 <br /> EV5655BC891A64473 <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: Reserved 10 rooms on April 10'due to urgency of anticipated need. <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 oocu igned by:- `ins,and requirements: <br /> asa �,bb 4/16/2020 <br /> Office of the Risk Management Officer Date: <br /> 7F6CF817E800495... <br /> Financial Services <br /> This instrument has been pre-audited in the manner req oocusigned by: iment Budget and Fiscal Control Act: <br /> 4/20/2020 <br /> Office of the Chief Financial Officer 7❑aESaa,Acc�aos... Date: <br /> Legal Services <br /> This agreement is approved as to legal form and OoeuSigned by: <br /> Office of the County Attorney ` '° - Date: 4/20/2020 <br /> E4035CB8304CA4M... <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 /> 10 <br />