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DocuSign Envelope ID: DB61356E-7ACB-4248-A6B4-08C4BC04350D <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Deuartment <br /> Party/Vendor Name: The Exchange Club's Family Center in Alamance Party/Vendor Contact Person: Cynthia <br /> Napoleon-Hanger Contact Phone: 336-748-9028 Party/Vendor Address: 200 N.Main Street City Graham State:NC <br /> Zip: 27253 Department: Finance & Adm. Srv. Amount:$ 2,000 Purpose: Outside Agency Performance Agreement <br /> Budget Code(s): 10495050 719069 Vendor 4 62677 (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 tec ' , .c gR. d,�WO� content: <br /> Department Director's Signature L232DFFC2CFA847B m/,L to D""`bvu Date: 8/18/2015 <br /> .. <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 /> ''111L <br /> Office of the Risk Management Officer PCs& 6bvvt,e,ttb Date: 8/18/2015 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the WW jrl;guired by the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer , Date: 8/18/2015 <br /> 232DFFC2CFA847B... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> ned by: <br /> Office of the County Attorney F7, 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 /> (The Exchange Club's Family Center in Alamance) <br /> Orange County Outside Agency Performance Agreement Page 6 of 7 <br /> Rev. 6115 <br />