HomeMy WebLinkAboutR 2020-229 DEAPR - Nisthith Trivedi martial arts contract amendment DocuSign Envelope ID:C4A937E8-092C-4556-AF04-77BA42FA4860
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: Nishith Trivedi Party/Vendor Contact Person: Nishith Trivedi Contact Phone: 757.339.9090
Party/Vendor Address: 622 Childsbere Way City Hillsborough State: NC Zip: 27278 Department: DEAPR-
Recreation Amount: $4250.00 Purpose: Martial Arts and Self-Defense Instruction Budget Code(s): 10511020
630000 Vendor# 64927 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type:
(Check one)New ❑ Renewal ❑ Amendment ® Effective Date March 16,2020 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:
q�DocuSigned by:
ylawl ���r� 3/20/2020
Department Director's Signature a11CFAM5o7A495... 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, -oocusigpned by: •ds, specifications,and requirements:
aUsa (per 6 3/20/2020
Office of the Risk Management Officer 7FDCF9176800498... Date:
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act: DocuSigned by:
0 3/26/2020
Office of the Chief Financial Officer 7DaE5a81ACC14a9... Date:
Legal Services
This agreement is approved as t DocuSigned by: iciency:
�6� K6k� 3/28/2020
Office of the County Attorney EAAM3sEDSAW5... 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 11/19 LE