Orange County NC Website
DocuSign Envelope ID: F66BAD96-D545-46F4-B22E-5CBE1864555A <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Deuartment <br /> Party/Vendor Name: Habitat for Humanity. Orange County, NC, Inc. Party/Vendor Contact Person: Susan Levy <br /> Contact Phone: (919)932-7077 Party/Vendor Address: 88 Vilcom Center Drive, Suite L110 City Chapel Hill State: <br /> NC Zip: 27514 Department: Finance & Adm. Srv. Amount:$ 20,000 Purpose: Outside Agency Performance <br /> Agreement Budget Code(s): 10495050 710023 Vendor 4 800020 (N/A if new vendor) Vendor is a BOCC <br /> consultant? Yes ❑NoX Contract Type: (Check one)New ❑ Renewal ❑ Amendment ❑ Effective Date July 1 <br /> 2015 Approved by Board YesX No❑ Agenda Date:June 16,2015 <br /> This agreement is approved as to tec °"¢ eM ontent: <br /> I q,�'(, pm 9/15/2015 <br /> Department Director's Signature 232DFFC2CFA847B... Date: <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 9eacffwedAnndards,specifications,and requirements: <br /> C7.So, (6vvt,e b 9/15/2015 <br /> Office of the Risk Management Officer nc�si7�AnnaaR Date: <br /> Financial Services <br /> This instrument has been pre-audited i Dx1q squired by the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer VU Date: 9/15/2015 <br /> Legal Services <br /> This agreement is approved as to le iand W.fficiency: <br /> [ 4"Jj Office of the County Attorneys Date: 9/17/2015 <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 /> (Habitat for Humanity, Orange County,NC Inc) <br /> Orange County Outside Agency Performance Agreement Page 7 of 7 <br /> Rev. 6115 <br />