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DocuSign Envelope ID:6D93A671-B4B5-4AC8-9EAC-8F9F070B5EDA <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Deuartment <br /> Party/Vendor Name: The Arc of the Triangle Party/Vendor Contact Person: Robin Baker Contact Phone: 919 942- <br /> 5119 Party/Vendor Address: 208 North Columbia Street, Suite 100 City Chapel Hill State: NC Zip: 27514 <br /> Department: Finance & Adm. Srv. Amount:$ 5,000 Purpose: Outside Agency Performance Agreement Budget <br /> Code(s): 10495050 719023 Vendor 4 50706 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ NoX <br /> Contract Type: (Check one)New ❑ Renewal ❑ Amendment ❑ Effective Date July 1,2015 Approved by Board <br /> YesX No❑ Agenda Date:June 16,2015 <br /> This agreement is approved as to technic form d content: <br /> ocu$igned-by: <br /> 7/29/2015 <br /> Department Director's Signature blti Date: <br /> 232DFFC2CFA847B... <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is <br /> approved as to information technology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> 5AUS.DocuSigned""by:''11LL Office of the Risk Management Officer (,bvvt,e,ttb Date: 7/29/2015 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in CPmamigamwguired by the Local Government Budget and Fiscal Control Act: <br /> XIAL �,A+bvu <br /> Office of the Chief Financial Officer Date: 7/29/2015 <br /> Legal Services <br /> This agreement is approved as to 1 %T1W tufficiency: <br /> Office of the County Attorney Date: 7/29/2015 <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ DolloyLyorangecou go v <br /> The following signature block is for hard copies only and is not required for Docusign contracts: <br /> Office of the Clerk to the Board Date: <br /> (The Arc of the Triangle) <br /> Orange County Outside Agency Performance Agreement Page 6 of 7 <br /> Rev. 6115 <br />