HomeMy WebLinkAboutR 2017-512-E Aging - Benjamin Rosado - MAP intern DocuSign Envelope ID:30AA40B6-A75F-4D67-935B-7965AF21 ECE5
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Benjamin Rosado Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: 105 A/B W Can Street City Carrboro State: NC Zip: 27510 Department: Aging Amount: $2,000 Purpose:
MAP Intern Budget Code(s): 10430020-630120 Vendor # 64708 (N/A if new vendor) Vendor is a BOCC
consultant? Yes ❑ No Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date 8/20/17
Approved by Board Yes' No Agenda Date:
This agreement is approved as to technical form and content:
/^--DocuSigned by:
Department Director's Signature J 1GL pttA,V' Date: 9/13/2017
B7E962D1BF454FA...
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:
r---DocuSigned by:
Office of the Risk Management Officer MS& CbYliuth Date: 9/14/2017
7FDCF9176800498...
Financial Services
This instrument has been pre-audited in the rreouired by the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer
9/14/2017
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—7D4E5181 ACC1409...
Legal Services
This agreement is approved as to l i for�tn and sufficiency:
ocu igne y:
a,AAAA. hark, -Nto 9/14/2017
Office of the County Attorney Date:
079A4D525C0F4FB...
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