HomeMy WebLinkAboutR 2017-508-E DEAPR - Amiel Elbitar-Hartwell for Start Smart Lacrosse instruction DocuSign Envelope ID: C9EA0B0B-2780-4A41-84A0-8B172AF2D4AA
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Amiel Elbitar-Hartwell Party/Vendor Contact Person: Amiel Elbitar-Hartwel Contact Phone:
919-724-0260 Party/Vendor Address: 2701 Homestead Road Apt. 208 City Chapel Hill State: NC Zip: 27516
Department: DEAPR Amount: $567.00 Purpose: Start Smart Lacrosse Budget Code(s): 10511020 630000 Vendor#
N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one) New
Renewal❑ Amendment ❑ Effective Date 9/11/2017 Approved by Board Yes No Agenda Date:
This agreement is approved as to to � f t f'f�YXiid content:
avu# gay tt 9/9/2017
Department Director's Signature 611LEA1n5n7A4Q5_ 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 sufficienc 4 Lunt standards,specifications,and requirements:
QiSa Cart e tt0 9/11/2017
Office of the Risk Management Officer 7EnCEQVRRnn4QR Date:
Financial Services
This instrument has been pre-audited i 42�xf dPaquired by the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer � � Date: 9/11/2017
794E54-89 ACC 1443s...
Legal Services
This agreement is approved as to °R Mrr sufficiency:
b(UA. bt S 9/11/2017
Office of the County Attorney Date:
EAAS9aa�ea6s...
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd @orangecountync.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 2/17 5
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