R 2015-496-E Co. Mgr. - Community Empowerment Fund for Integrated Services Center rent

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DocuSign Envelope ID: D09F6D26-5288-40CE-99DB-DBA8FE0850B6 ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Community Empowerment Fund Party/Vendor Contact Person: Maggie West Contact Phone: (919) 270-5730 Party/Vendor Address: 108 W. Rosemary Street City Chapel Hill State: NC Zip: 27516 Department: County Manager's Office Amount: $12,000 Purpose: Integrated Services Center rent Budget Code(s): 32470620 680022 Vendor# (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New ® Renewal❑ Amendment ❑ Effective Date 51112015 Approved by Board Yes❑No ❑ Agenda Date: This agreement is approved as to technigal Writ sand content: ocu igne y: Department Director's Signature E—�0637994B755E477_ov�,�►e, ( AMmt,V'S� Date: 9/11/2015 Information Technologies (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer Date: Risk Management This agreement is approved for sufficiency of insurance standards,specifications,and requirements: -DocuSigned""by:''111L Office of the Risk Management Officer AUS0, 66vvt,e 6 Date: 9/11/2015 7FDCF9176800498... Financial Services This instrument has been pre-audited in th.%ni ed gaguired by the Local Government Budget and Fiscal Control Act:oc Office of the Chief Financial Officer Pm/,L (, 4ym Date: 9/11/2015 232DFFC2CFA847B... Legal Services This agreement is approved as to le l fspgrnmedyid sufficiency: Office of the County Attorne 44 Date: 9/11/2015 4035CB8304CA4A9... Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ DolloyLyorangecoun.nc.gov The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board Date: 6