HomeMy WebLinkAboutR 2016-212-E Aging - Lauren Shiplett for MAP summer intern DocuSign Envelope ID: 14D37718-BEAE-4494-8BD9-AC8FC1C8COOB
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Lauren Shiplett Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: 5819 Acorn Knoll Place City Mebane State: NC Zip: 27302 Department: Aging Amount: $1,350.00
Purpose: MAP Summer Intern Budget Code(s): 10430020-630120 Vendor#62884 (N/A if new vendor) Vendor is
a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective
Date 05/09/16 Approved by Board Yes❑No❑ Agenda Date:
This agreement is approved as to technical forth and content:
5zDocuSigned by:
&Department Director's Signature fi�v Date:4/18/2016
67E962D1BF454FA...
Information Technolosies
(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:
DocuSigned by: 11i1
Office of the Risk Management Officer pllS. ('6n' '',ll b Date: 4/19/2016
7FDCF9176800498...
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
DocuSigned by:
Office of the Chief Financial Officer Date: 4/19/2016
7D4E5181ACC1409...
Legal Services
This agreement is approved as to legal form and sufficiency:
DocuSigned by:
Office of the County Attorney In,_ Date: 4/19/2016
4035CB8304CA4A9...
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloy(d c�orangecount.nic.gov
The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board Date:
Revised 1/16 4