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Page 7 of 6 <br />Revised 2/2019 <br /> <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br />Department <br /> <br />Party/Vendor Name: Orange County Board of Education Party/Vendor Contact Person: Michele Woodson Contact <br />Phone: 919-245-4001 Party/Vendor Address: 1914 New Hope Church Road City Chapel Hill State: NC Zip: 27514 <br />Department: Health Amount: $11,656.71 Purpose: Provide summer k-readiness and literacy program Budget <br />Code(s): 30412020-680007/630000-71453 Vendor # 178 (N/A if new vendor) Vendor is a BOCC consultant? Yes <br /> No X Contract Type: (Check one) New  Renewal X Amendment  Effective Date 6/1/21 Approved by Board <br />Yes No Agenda Date: <br /> <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 /> <br /> <br />Department Director’s Signature ________________________________________ 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: Were waiting on approval to sub-grant funds from United Way. <br /> <br />Information Technologies <br /> <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 /> <br />Office of the Chief Information Officer___________________________________ Date: ________ <br /> <br />Risk Management <br /> <br />This agreement is approved for sufficiency of insurance standards, specifications, and requirements: <br /> <br />Office of the Risk Management Officer___________________________________ Date: _________ <br /> <br />Financial Services <br /> <br />This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> <br />Office of the Chief Financial Officer ____________________________________ Date: _________ <br /> <br />Legal Services <br /> <br />This agreement is approved as to legal form and sufficiency: <br /> <br />Office of the County Attorney __________________________________________Date: ________ <br /> <br /> <br />Clerk to the Board <br /> <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 /> <br />Office of the Clerk to the Board __________________________________________Date:_________ <br /> <br />DocuSign Envelope ID: A5DFA30D-6B93-46CB-8234-C7E2AAD7EE0E <br />7/9/2021 <br />7/14/2021 <br />7/14/2021 <br />7/15/2021