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DocuSign Envelope ID:ADF76E75-8A91-4F91-BD39-9EB44F59669A <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Deuartment <br /> Party/Vendor Name: Charles House Association Party/Vendor Contact Person: Paul Klever Contact Phone: 919- <br /> 967-7570 Party/Vendor Address: 109 Hillcrest Avenue City Carrboro State: NC Zip: 27510 Department: Finance <br /> & Adm. Srv. Amount:$ 15,000 Purpose: Outside Agency Performance Agreement Budget Code(s): 10495050 <br /> 710029 Vendor 4 800031 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ NoX Contract Type: <br /> (Check one)New ❑ Renewal ❑ Amendment ❑ Effective Date July 1,2015 Approved by Board YesX No❑ <br /> Agenda Date: June 16,2015 <br /> This agreement is approved as to techni gd,vAp.ontent: <br /> Department Director's Signature I pm/,L t,a+bvu Date: $/5/2015 <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 /> DocuSigned""by: <br /> ''11 <br /> QllStU (6vvt,&b 8/5/2015 <br /> Office of the Risk Management Officer Date: <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the pagneerdrbyquired by the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer <br /> m Date: 8/5/2015 <br /> 232DFFC2CFA847B... <br /> Legal Services <br /> This agreement is approved as to legal f ryypp and ufficiency: <br /> �ocu�igned Uy: <br /> Office of the County Attorney F4jd WIj— Date: 8/5/2015 <br /> 4035CB8304CA4A9... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ DolloydLvorangecoul Utne.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 /> (Charles House Association) <br /> Orange County Outside Agency Performance Agreement Page 6 of 7 <br /> Rev. 6115 <br />