Orange County NC Website
Revised 06/21 <br /> <br /> <br />4 <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br /> <br />Party/Vendor Name: Frog Pond Farm NC Party/Vendor Contact Person: Helen Ingersoll Contact Phone: N/A <br />Party/Vendor Address: 316 Hawkins Rd City Cedar Grove State: NC Zip: 27231 Department: CJRD Amount: <br />$4,999 Purpose: Programming Budget Code(s): 10212020-630000 Vendor # 67786 (N/A if new vendor) Vendor is <br />a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective <br />Date 8/1/22 Approved by Board Yes No Agenda Date: June 2022 --- For Section XIV. c. contracts only, <br />Approved by Board in Current FY Budget Yes No <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 />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 was <br />addressed: N/A <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 />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: 54DFA2A2-E757-44BE-93FC-89E3F44EDE5B <br />11/9/2022 <br />11/9/2022 <br />11/9/2022 <br />11/10/2022