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DocuSign Envelope ID: 716FBOE9-5CE9-44F5-9BAC-48D7E4C96CD6 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Deuartment <br /> Party/Vendor Name: Human Rights Center of Chapel Hill & Carrboro Party/Vendor Contact Person: Asif Khan <br /> Contact Phone: 919590-5980 Party/Vendor Address: 109 N. Graham Street City Chapel Hill State: NC Zip: 27516 <br /> Department: Finance & Adm. Srv. Amount:$ 1,000 Purpose: Outside Agency Performance Agreement Budget <br /> Code(s): 10495050 719059 Vendor 4 62069 (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 techni gj.t9 AAgd content: <br /> � <br /> ���(�� 8/13/2015 <br /> Department Director's Signature �A t"-"'D"�bvu 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 ipsig�ne�""bst''al1nLdards,specifications,and requirements: <br /> Office of the Risk Management Officer aUs& (,bvvu,ttb Date: 8/13/2015 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> DocuSigned by: <br /> Office of the Chief Financial Officer <br /> bVu Date: 8/13/2015 <br /> 232DFFC2CFA847B... <br /> Legal Services <br /> This agreement is approved a to le alpfo� na �ysufficiency: <br /> 8/13/2015 <br /> Office of the County Attorney ✓ Date: <br /> 4035CB8304CA4A9... <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 /> (Human Rights Center of Chapel Hill& Carrboro) <br /> Orange County Outside Agency Performance Agreement Page 6 of 7 <br /> Rev. 6115 <br />