HomeMy WebLinkAboutR 2016-523-E Health - YMCA of the Triangle, Inc. for afterschool Y Learning Program at New Hope Elem. School DocuSign Envelope ID:OFED21311-8255-4593-8131F-CEF2E643BCF2
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: YMCA of the Triangle.Inc. Party/Vendor Contact Person: Aubrey Vinson Contact Phone: 919-
442-9622 Party/Vendor Address: 980 MLK Jr. Blvd City Chapel Hill State: NC Zip: 27514 Department: Health
Amount: $2,500 Purpose: Provide an after school Y Learning program at New Hope elementary. Budget Code(s):
10412020-630000-71453 Vendor # 52475 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No®
Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 9/1/16 Approved by Board Yes
❑No❑ Agenda Date:
This agreement is approved as to to ndc��`o1�d tnt:
('�(� 9/12/2016
Department Director's Signature cseosooFCSesase... Date:
Information Technologies
(Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is
approved as to information technology content and specifications:
Office of the Chief Information Officer Date:
Risk Management
This agreement is approved for sufficiency iiqst '_)stanndards,specifications,and requirements:
a�tSA. rbvvutl6 9/12/2016
Office of the Risk Management Officer so, n�$ Date:
Financial Services
This instrument has been pre-audited i e°li'WIMP�6:quired by the Local Government Budget and Fiscal Control Act:
Lj-t-A `�°" '`"L 9/13/2016
Office of the Chief Financial Officer Date:
Legal Services
This agreement is approved as tcr 016imfAd sufficiency:
Office of the County Attorney L 40 4V-_ Date: 9/13/2016
4ea5eBaB D_
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dollo d&oran etync.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 6/16 5