HomeMy WebLinkAboutR 2019-233 Health - Chapel Hill Carrboro Schools FPG summer camp DocuSign Envelope ID:20118219-A7E9-41F1-A36D-44700C004BFC
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Chapel Hill Carrboro City SchoolsParty/Vendor Contact Person: Jessica O'Donovan Contact
Phone: 919-967-8211 x28225 Party/Vendor Address: 750 S. Merritt Mill Road City Chapel Hill State: NC Zip:
27516 Department: Health Amount:J62 388 Purpose: FPG Enrichment Camn Budget Code(s): 10412020-630000-
71453Vendor#22226 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No ® Contract Type: (Check
one)New ❑ Renewal X Amendment ❑ Effective Date 5-1-19 Approved by Board Yes❑ No❑ Agenda
Date:
This agreement is approved as to technical form and content and I as Department Director affirmatively state work on
this project has not been initiated prior to execution of the agreement:
DocuSigned by:
S�_Wof 4/10/2019
Department Director's Signature aCisF2DosEsaa5F" Date:
Agreements for emergency services or repair are not subject to the above affirmation. If services related to this
agreement have already begun or been completed please briefly describe the nature of the emergency condition that
was addressed:
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 sufficient Wocusigned by: rds,specifications,and requirements:
�,bVln.t,{�6 4/10/2019
Office of the Risk Management Officer 7��$�.FDCF91768004M" Date:
Financial Services
This instrument has been pre-audited i Docusigned by: the Local Government Budget and Fiscal Control Act:
4 4/15/2019
Office of the Chief Financial Officer 704E51S1ACC1409" Date:
Legal Services
This agreement is approved as tc11"
" Doeusigned by:
J, f.a.Y'f, �$cb 4/15/2019
Office of the County Attorney Date:
079A4D525C0F4FB.
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:
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Revised 212019