HomeMy WebLinkAboutR 2016-289-E DSS - Leading To Change for Youth Summit training DocuSign Envelope ID:A8CC6099-BBB9-4DBF-BE9D-2C2A34EF376C
ORANGE COUNTY--DEPARTMENT USE ONLY
Department
Party/Vendor Name: Leading"To Change Party/Vendor Contact Person: Eric Rowles Contact Phone: (704)595-1789
Party/Vendor Address: 9815 Sam Furr Rd. City Huntersville State: NQ Zip: 28078 Department: Social Services
Amount: 2850 Purpose: Youth Summit Training Budget Code(s): 3046020761..00071082 Vendor 4 NA (N/A if new
vendor) Vendor is a BOCC consultant? Yes ❑ NoZ Contract 'Type: (Check one) New Z Renewal ❑
Amendment ❑ Effective Date 05/23/2016 Approved by Board YesD NoZ Agenda Date:NA
This agreement is approved as to technical form an co iftfl tigned by:
N N," 666vu 6/10/2016
k
Department Director's Signature Date:
Information Technolojies
(Applicable only to hardwarelsoftw1are 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 insuranc ndapdop6 pecifications,and requirements:
(hvvkN 6/10/2016
Office of the Risk Management Officer Date:
Financial Services
This instrument has been pre-audited in the manner equ4Pfl"YINl Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer Lita Date: 6/10/2016
Le2al Services
�
o rigned ed b e b
This agreement is approved.as to legal form and sufic—ie ,
L��� 6/10/2016
Office of the County Attorney
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Eqnro q qy
q,L ggy
�� E 1 L
The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board
Revised 1/16 4
----------