HomeMy WebLinkAboutR 2018-554 Health - YMCA after school servicesRevised 10/17
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ORANGE COUNTY—DEPARTMENT USE ONLY
______________________________________________________________________________
Department
Party/Vendor Name: YMCA of the Triangle, Inc. Party/Vendor Contact Person: Aubrey Vinson Contact Phone:
919-442-9622 Party/Vendor Address: 980 MLK Jr. Blvd City Chapel Hill State: NC Zip: 27514 Department:
Health Amount: $2,500 Purpose: Provide an after school Y Learning program at New Hope elementary. Budget
Code(s): 10412020-630000-71453 Vendor # 52475 (N/A if new vendor) Vendor is a BOCC consultant? Yes
No Contract Type: (Check one) New Renewal Amendment Effective Date 9/1/17 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 Docusign contracts:
Office of the Clerk to the Board __________________________________________Date:_________
DocuSign Envelope ID: 2D232CEA-B53A-4F88-8254-9E5614B35A63
1/3/2018
1/5/2018
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1/5/2018