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Docusign Envelope ID:3EAC63A1-E275-4337-928E-E4701947E6BF <br /> ORANGE COUNTY-INTERNAL USE ONLY <br /> Finance Information <br /> Vendor Name: Nishith Trivedi Vendor Contact Person: Nishith Trivedi Phone: (757)339-9090 Address: 622 <br /> Childsbere Way City Hillsborough State:NC Zip:28278 Department:DEAPR-Recreation Amount: $4,074.00 <br /> Purpose: Martial Arts&Tai Chi Instruction Budget Code(s): 10511020 630000 Vendor#64327 <br /> Vendor Status with NCSOS: Vendor is a BOCC consultant: ❑Yes ®No <br /> Contract Details <br /> Contract Type: ®New ❑Amendment(Original Contract: )(Most Recent Amendment ) <br /> Effective Date July 12,2025 End Date June 30,2026 Notice Date (Notice Purpose ) <br /> Award <br /> ❑Approved by Board(Agenda Date: Made or Administered by <br /> Signature Authority <br /> ❑ BOCC Express Delegation(Agenda Date: <br /> - Policy 9.4: ®Under$5,000; ❑ Service Under$90,000; ❑ Construction Under$250,000 <br /> - ❑ Budget Policy Section XV(Capital Improvement Project: <br /> Bidding <br /> ❑ Informal Bidding($30k-$90k); ❑Formal RFP($90k+); ❑ Other(<$30k); ❑ Exception(#-----) <br /> Department Affirmation <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 /> ❑ This agreement is approved as to technical form and content. Services related to this agreement have already begun <br /> or been completed.Description of th A@@ .U:emergency condition that was addressed: <br /> Department Director's Signature vAvt, sl6UA t Date:6/29/2025 <br /> fill CFA1 D507A495... <br /> Information Technologies <br /> This agreement has been reviewed and is approved as to information technology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> ®Inapplicable because no hardware/software purchases or related services <br /> Risk Management <br /> This agreement is approved for sufficienc n°s>�e�xra�nce standards,specifications,and requirements: <br /> INIt4.,4, fit,,,,, Date:6/30/2025 <br /> Office of the Risk Management Officer <br /> Financial Services <br /> This instrument has been pre-audited ii etitpmgmorwquired by the Local Government Budget and Fiscal Control Act: <br /> C�14,v Office of the Chief Financial Officer, �bl.rcr05.o0l. <br /> y Date: 6/30/2025 <br /> Legal Services <br /> This agreement is approved as t cntd sufficiency: <br /> halt,ln, ��� / / <br /> Office of the County Attorney J Date:7 1 2025 <br /> Clerk to the Board <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 /> Received for record retention: <br /> Revised 01/24 4 <br /> Initial <br />