HomeMy WebLinkAboutR 2019-728 Health - Racial Equity Institute groundwater training DocuSign Envelope ID: F65EOD95-4748-43OB-B7D4-57947C3D102E
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Racial Equity Institute, LLC Party/Vendor Contact Person: Megan Hayes-Bell Contact
Phone: 336-362-3533 Party/Vendor Address: 454 Gorrell St. City Greensboro State:NC Zip: 27406 Department:
Health Amount: $5,500 Purpose: Racial Equity Groundwater Presentation Budget Code(s): 10412020-630000-
71460 Vendor#N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check
one) New ® Renewal ❑ Amendment ❑ Effective Date 10-9-19 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&Wo- 10/2/2019
Department Director's Signature_ sCisF20osEsa45F. 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 �ocusigned by: rds,specifications,and requirements:
aUS& �,bV1n.A6 10/2/2019
Office of the Risk Management Office El
. Date:
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act: DocuSigned by:
A " 10/7/2019
Office of the Chief Financial Officer 7oaE5aa1ACC1409. Date:
Legal Services
d by:e
This agreement is approved as t OocuSign .{�
9WAk f, l�5� 10/7/2019
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: 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
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