Orange County NC Website
Page 6 of 6 <br />Revised 3/2020 <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br />Department <br /> <br />Party/Vendor Name: Chapel Hill Carrboro City SchoolsParty/Vendor Contact Person: Jessica O'Donovan Contact <br />Phone: 919-967-8211 x28225 Party/Vendor Address: 750 S. Merritt Mill Road City Chapel Hill State: NC Zip: <br />27516 Department: Health Amount: $72,500Purpose: Online summer k-readiness program Budget Code(s): <br />10414020-630000-71453Vendor # 22226 (N/A if new vendor) Vendor is a BOCC c onsultant? Yes No <br />Contract Type: (Check one) New Renewal X Amendment Effective Date 6-1-20 Approved by Board Yes <br /> 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: Due to COVID-19, the original contract for summer camps was cancelled and a new program needed <br />to be agreed upon. <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 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 /> <br />Office of the Clerk to the Board __________________________________________Date:_________ <br /> <br />DocuSign Envelope ID: C51F630A-23FD-4386-B0CE-9526161D6CC7 <br />6/12/2020 <br />6/12/2020 <br />6/22/2020 <br />6/22/2020