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DocuSign Envelope ID: B663A826-96F2-42AC-9318-450A8E98CC55 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: State ESG Office Party/Vendor Contact Person: Lisa Worth Contact Phone: 919 <br /> 855-4993 Party/Vendor Address:2101 Mail Service Center City Raleigh State:NC Zip: 27699 Department: <br /> OCHCD Amount:no bud et im lications-certifications needed for grant award <br /> Purpose: ESG F -21 Uidget Code(s): N/A Vendor #N/A W/A if new Ue dor) Vendor is a❑BOCC <br /> consultant? Yes No K-ontract Type (check one)New Renewal Amendment Effective Date <br /> 11/18/20 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 /> 11/18/2020 <br /> Department Director's Signature D42B075CF42M7... 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 of' }%§tpdards,specifications,and requirements: <br /> Q�Sa rbvvulTb 11/19/2020 <br /> Office of the Risk Management Officer Date: <br /> 498 <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 /> aAtiy +�ost�'i„m 11/19/2020 <br /> Office of the Chief Financial Officer O 101. Date: <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: 11/19/2020 <br /> Office of the County Attorney E.— A _, , I�,,, Date: <br /> vubut, <br /> 079A4D525COF4FB... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@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 07/20 <br /> 9 <br />