HomeMy WebLinkAboutR 2015-491 Aging - Town of Chapel Hill for Senior Services
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Town of Chapel Hill Party/Vendor Contact Person: William Webster Contact Phone: 919-
968-2819 Party/Vendor Address: 405 Martin Luther King Jr Blvd City Chapel Hill State: NC Zip: 27514
Department: Aging Amount: $50,000 Purpose: Senior Services Budget Code(s): 10430105-444002 Vendor#64
(N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑
Renewal ® Amendment ❑ Effective Date 7/01/2015 Approved by Board Yes❑ No❑ Agenda
Date:
This agreement is approved as to technical form and content:
Department Director's Signature Date: —.-
Information Technologies
(Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is
approved as to information technology content and specifications:
Office of the Chief Information Officer Date:
Risk Management
This agreement is approved for sufficiency of insurance standards,specifications,and requirements:
Office of the Risk Management Officer , z � per` Date: J
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act:
Office of the Chief Financial Officer T� Q Date:
bo
Legal Services
This agreement is approved as to legal and s ciency:
Office of the County Attorney Date: �? 1�
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@orangecogntync.gov
The following signature block is for harSko ' s my and is not required for Docusign contracts:
Office of the Clerk to the Board Date: