HomeMy WebLinkAboutR 2019-007 Health - CHCCS Carrboro Elementary after school program DocuSign Envelope ID:2ED162C9-56B4-4E3B-B5E1-D362BBB00188
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Chapel Hill Carrboro County Schools Party/Vendor Contact Person: Charlos Banks Contact
Phone: 919-967-8211 x28244 Party/Vendor Address: 750 S. Merritt Mill Road City Chapel Hill State: NC Zip:
27516 Department: Health Amount: $2,500 Purpose: After school programming at Carboro Elementar. Budget
Code(s): 10412020-630000-71453 Vendor#22226 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No
® Contract Type: (Check one)New ❑ Renewal ® Amendment ❑ Effective Date 10/15/18 Approved by Board
Yes❑No❑ Agenda Date:
This agreement is approved as to to Docusigned by:
6WKjia' S&WAk 1/3/2019
Department Director's Signature 3c16F2D09E3445F. 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 DocuSigned by: rds,specifications,and requirements:
QUS66 �,bVln.f,{�6 1/3/2019
Office of the Risk Management Office 7F❑cFe176900498. Date:
Financial Services
This instrument has been pre-audited it Docusigned by: the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer LI-N 4 Date:1/3/2019
NE5181ACC1400-
Legal Services
This agreement is approved as t DocuSigned by:
��x- �t, T 6S(h 1/3/2019
Office of the County Attorney 079A4D525c0F4FB. Date:
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Sherri Ingersoll upon completion: sin erp sollkoran_ep countync.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 10/17(Mgr appry 5k 6/18) 4