HomeMy WebLinkAboutR 2018-013 DEAPR - Neshith Trivedi Martial Arts InstructionRevised 10/17
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ORANGE COUNTY—DEPARTMENT USE ONLY
______________________________________________________________________________
Department
Party/Vendor Name: Nishith Trivedi Party/Vendor Contact Person: Nishith Trivedi Contact Phone: (757) 339-
9090 Party/Vendor Address: 622 Childsberg Way City Hillsborough State: NC Zip: 27278 Department: DEAPR-
Recreation Amount: $5,040.00 Purpose: Martial Arts Instruction Budget Code(s): 15011020 630000 Vendor #
(N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New
Renewal Amendment Effective Date 1/1/2018 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:
Office of the Risk Management Officer___________________________________ Date: _________
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act:
Office of the Chief Financial Officer ____________________________________ Date: _________
Legal Services
This agreement is approved as to legal form and sufficiency:
Office of the County Attorney __________________________________________Date: ________
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 Do cusign contracts:
Office of the Clerk to the Board __________________________________________Date:_________
DocuSign Envelope ID: 58F775EE-EF07-4AEC-AF20-BC421F1E9F16
1/11/2018
1/11/2018
1/11/2018
1/11/2018