Orange County NC Website
DocuSign Envelope ID:A2DC2EF9-6C9A-438D-A97D-84CEA493644C <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Kidzu Children's Museum Party/Vendor Contact Person Lisa Van Deman Contact Phone: <br /> 919/933-1455 Party/Vendor Address: 201 S.Estes Dr Suite A9 City Chapel Hill State:NC Zip: 27514 Department: <br /> Cnty Manager Amount: $13,301 Purpose:20-21 Outside Agencies Grant Budget Code(s): 10692020 720274 Vendor <br /> #60102 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New❑ <br /> Renewal❑ Amendment ❑ Effective Date 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 /> DocuSigned by: <br /> Department Director's Signature �r_r S run, Date: 2/15/2021 <br /> Agreements for emergency services� &tMfVftWsubject 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 insurance standards,specifications,and requirements: <br /> DocuSigned""by. <br /> '' <br /> Office of the Risk Management Officer USA, (hmk i11ii <br /> b Date: 2/15/2021 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in thegj@41 iS brpuired by the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officerr_r;-_M Date: 2/15/2021 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to 1 BJfATJaa4d sufficiency: <br /> Office of the County Attorney mu_ Date: 2/21/2021 <br /> 4035CB8304CA4A9... <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 /> Orange County Outside Agency Performance Agreement Page 6 of 9 <br /> Rev. 1121 <br />