HomeMy WebLinkAboutR 2019-392 DEAPR - Antonio Rafael lacrosse camp DocuSign Envelope ID:COF94A42-7FOE-4EA7-9BAB-700005351OC3
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Antonio Aguilar Party/Vendor Contact Person: Antonio Aguilar Contact Phone: 336-263-0050
Party/Vendor Address: 498 Stonewall Drive City Mebane State: NC Zip: 27302 Department: DEAPR-Recreation
Amount: $2,450.00 Purpose: Lacrosse Summer Camps Instruction Budget Code(s): 10511020 630000 Vendor #
64683 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New
Renewal ❑ Amendment ❑ Effective Date July 15, 2019 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:
'Ja�� ����� 6/30/2019
Department Director's Signature 611cFA1D507A495.. 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 sufficienc---rD-*o-c-uSi9-ned-b-y:-`--'-rds, specifications,and requirements:
�U$66 �,DVln.t 6 6/30/2019
Office of the Risk Management Office Datc:
7FDCF9178800498.
Financial Services
This instrument has been pre-audited i Docusigned by: the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Office A . Date:6/30/2019
7D4E5181 AM 4M
Legal Services
This agreement is approved as tc Do cusigned by, iciency:
Office of the County Attorney Date:7 1 2019
EAA3D33ED8AE4S5..
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:
Revised 12/18 4
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