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DocuSign Envelope ID: B9586FD4-5663-4F3F-8147-A6259742B4B5 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: El Futuro, Inc. Party/Vendor Contact Person: Luke Smith, MD Contact Phone: 919.688.7101 <br /> Party/Vendor Address: 136 E Chapel Hill Street City Durham State: NC Zip: 27701 Department: Finance & Adm. <br /> Srv. Amount:$ 27,500 Purpose: Outside Agency Performance Agreement Budget Code(s): 10495050 719049 <br /> Vendor 4 57915 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ NoX Contract Type: (Check one) <br /> New ❑ Renewal ❑ Amendment ❑ Effective Date July 1, 2015 Approved by Board YesX No❑ Agenda <br /> Date: June 16,2015 <br /> This agreement is approved as to techni fmagigpntent: <br /> Department Director's Signature r O'�4 to D""`bin, Date: 8/14/2015 <br /> 232DFFC2C FA847 B... <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 /> ri ,DocuSigneby:''11LL Office of the Risk Management Officer us& (,bnL b Date: 8/14/2015 <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 Office <br /> �A.U�, �,,A.IA UI Date: 8/14/2015 <br /> 232DFFC2CFA847B... <br /> Legal Services <br /> This agreement is approved as to le a�foam adaufficiency: <br /> ocu Igoe y <br /> Office of the County Attorney ✓ Date: 8/14/2015 <br /> 4035CB8304CA4A9... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ 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 /> (El Futuro,Inc) <br /> Orange County Outside Agency Performance Agreement Page 6 of 7 <br /> Rev. 6115 <br />