HomeMy WebLinkAboutR 2017-037-E Co. Mgr. - Carpe Diem for sustance use education DocuSign Envelope ID:8B974F86-8438-416C-9F8D-33AE69D5D195
ORANGE COUNTY---DEPARTMENT USE ONLY---HARD COPY ONLY
Department
Party/Vendor Name: Carpe Diem Party/Vendor Contact Person: Trish Halsey Contact Phone: 919-929-7087
Party/Vendor Address: PO Box 2414 City Chapel Hill State:NC Zip: 27515-2414 Department: CTY MGR/CJRO
Amount: $120 per referral Purpose: Substance Use Education Budget Code(s): 10212020-720133 Vendor#N/A
(N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑
Renewal❑ Amendment ❑ Effective Date 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:
DocuSigned by:
Office of Risk Management ((USX (OVtU. t Date:
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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 (21.4-N An Date:
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Legal Services
This agreement is approved as to legal form and sufficiency:.Signed by:
Office of the County Attorney i°' "-S Date:
328DC480549A4F5...
Clerk to the Board
Received for record retention:
Office of the Clerk to the Board Date:
Revised 6/16