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DocuSign Envelope ID: C50BD8FE-B3AB-441E-B415-6E21429FC05D <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Deuartment <br /> Party/Vendor Name: OC Disability Awareness Council Party/Vendor Contact Person: Timothy Miles Contact <br /> Phone: 919-245-4337 Party/Vendor Address: 503 W. Franklin Street Room 113 City Chapel Hill State: NC Zip: <br /> 27516 Department: Finance & Adm. Srv. Amount:$ 4,000 Purpose: Outside Agency Performance Agreement <br /> Budget Code(s): 10495050 710032 Vendor 4 800037 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ <br /> NoX Contract Type: (Check one)New ❑ Renewal ❑ Amendment ❑ Effective Date July 1,2015 Approved by <br /> Board YesX No❑ Agenda Date:June 16,2015 <br /> This agreement is approved as to technic dWntent: <br /> Department Director's Signature pm/,L t,a+bvu Date: 8/18/2015 <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:''11LL <br /> Office of the Risk Management Officer <br /> 5us . (,bvvte& Date: 8/17/2015 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in rpo'L}MRge� quired by the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer to+bvu Date: 8/18/2015 <br /> 232DFFC2CFA847B... <br /> Legal Services <br /> This agreement is approved as to le alpfo� na gysufficiency: <br /> Office of the County Attorney ✓ 0 Date: 8/18/2015 <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 /> (OC Disability Awareness Council) <br /> Orange County Outside Agency Performance Agreement Page 6 of 7 <br /> Rev. 6115 <br />