HomeMy WebLinkAboutR 2018-543 DEAPR - Amiel Elbitar-Hartwell Start Smart lacrosse instruction.docRevised 10/17 (Mgr apprv 5k 6/18)
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ORANGE COUNTY—DEPARTMENT USE ONLY
______________________________________________________________________________
Department
Party/Vendor Name: Amiel Elbitar-Hartwell Party/Vendor Contact Person: Amiel Elbitar-Hartwell Contact Phone:
Party/Vendor Address: 2701 Homestead Road Apt. 208 City Chapel Hill State: NC Zip: 27516 Department:
DEAPR-Recreation Amount: $567.00 Purpose: Start Smart Lacrosse Instruction Budget Code(s): 10511020 630000
Vendor # 64826 (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one)
New Renewal Amendment Effective Date Sept. 11, 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 Sherri Ingersoll upon completion: singersoll@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:_________
DocuSign Envelope ID: EC8F91F4-F2AD-4323-AB10-37E3190C8BA8