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DocuSign Envelope ID:8BB7B367-E293-48C0-8E6E-6C2D2ACBDD69 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Deuartment <br /> Party/Vendor Name: Orange Congregations in Mission-Samaritan Relief Ministry Party/Vendor Contact Person: <br /> Rev. Sharon S. Freeland Contact Phone: (919) 732-6194 x10 Party/Vendor Address: 300 Millstone Drive City <br /> Hillsborough State:NC Zip: 27278 Department: Finance&Adm. Srv. Amount:$ 33,415 Purpose: Outside Agency <br /> Performance Agreement Budget Code(s): 10495050 710031 Vendor 4 800010 (N/A if new vendor) Vendor is a <br /> BOCC consultant? Yes ❑NoX Contract Type: (Check one)New ❑ Renewal ❑ Amendment ❑ Effective Date <br /> July 1,2015 Approved by Board YesX No❑ Agenda Date:June 16,2015 <br /> This agreement is approved as to tec T Wrlffedftcontent: <br /> rp tA.+bvu 7/28/2015 <br /> Department Director's Signature �B�FaazB... Date: <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 o r�FDCF9 4WL ef'"t lid1aLrds,specifications,and requirements: <br /> SAu bvvte tt0 7/28/2015 <br /> Office of the Risk Management Officer 17680 0498... Date: <br /> Financial Services <br /> This instrument has been pre-audited in th 7P1a ferf iM ed by the Local Government Budget and Fiscal Control Act: <br /> M 7/28/2015 <br /> Office of the Chief Financial Officer 23 EA847A__ Date: <br /> Legal Services <br /> This agreement is approved as to 1 sufficiency: <br /> Office of the County Attorney �� Date: 2/28/2015 <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd yorangecou 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 /> (Orange Congregations in Mission-Samaritan Relief Ministry) <br /> Orange County Outside Agency Performance Agreement Page 7 of 7 <br /> Rev. 6115 <br />