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DocuSign Envelope ID: 78F206FF-A138-4129-88A7-AC03812E2BD1 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: The Art Therapy Institute Party/Vendor Contact Person: Kristin Linton Contact Phone: 919- <br /> 381-6068 Party/Vendor Address: 200 N. Greenboro St., Suite D-6, Carr Mill Mall City Carrboro State: NC Zip: <br /> 27510 Department: Finance & Adm. Srv. Amount:$ 1,000 Purpose: Outside Agency Performance Agreement <br /> Budget Code(s): 10495050 720109 Vendor 4 (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 �gm ,content: <br /> Department Director's Signature OMAL to D""`bvu Date: 8/14/2015 <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"" b by: <br /> ''1L <br /> Q�As& rbvvt,e <br /> Office of the Risk Management Officer Date: 8/14/2015 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in h aWq#X Epuired by the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer pm/,L tA+bvu Date: 8/14/2015 <br /> 232DFFC2CFA847B... <br /> Legal Services <br /> This agreement is approved as to le al ora ark sufficiency: <br /> ocu Igoe y: <br /> 8/14/2015 <br /> Office of the County Attorney ✓ Date: <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 Art Therapy Institute) <br /> Orange County Outside Agency Performance Agreement Page 6 of 7 <br /> Rev. 6115 <br />