HomeMy WebLinkAboutR 2016-688-E Health - CHCCS to provide afterschool tutoring to Northside Elem. students DocuSign Envelope ID:E4E01E48-2996-4D82-BC63-CF23EF83259D
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Chapel Hill Carrboro County Schools Party/Vendor Contact Person: Dr. Rydell Harrison
Contact Phone: 919-967-8211 Party/Vendor Address: 750 S. Merritt Mill Rd. City Chapel Hill State: NC Zip: 27516
Department: Health Amount: $2,484 Purpose: Provide an after school tutoring program to Northside Elementary
students Budget Code(s): 10412020-630000-71453 Vendor # 22226 (N/A if new vendor) Vendor is a BOCC
consultant? Yes ❑ No® Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date 12/1/16
Approved by Board Yes❑No❑ Agenda Date:
This agreement is approved as to to /f L3aM Wd content:
IN 12/2/2016
Department Director's Signature e �F 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, j�� migzb,.tanndards, specifications, and requirements:
a�iSa rbvvutl6 12/2/2016
Office of the Risk Management Officer FDC Date:
Financial Services
DocuSi ned b
This instrument has been pre-audited i the manner equired by the Local Government Budget and Fiscal Control Act:
('q-m 0°"�— 12/2/2016
Office of the Chief Financial Officer M4E5181ACC1409... Date:
Legal Services
This agreement is approved as t e 'YV?fi�d�ivid sufficiency:
-���- 1Z/Z/2016
Office of the County Attorney ao35cBaaoacAl— Date:
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