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DocuSign Envelope ID:8B670D51-A7FD-4694-8E94-963553021305 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Community Empowerment Fund Party/Vendor Contact Person: Maggie West Contact Phone: <br /> 919-270-5730 Party/Vendor Address: 108 W. Rosemary Street City Chapel Hill State:NC Zip: 27516 Department: <br /> Finance & Adm. Srv. Amount:$ 7,500 Purpose: Outside Agency Performance Agreement Budget Code(s): <br /> 10495050 719064 Vendor 4 61695 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ NoX Contract <br /> Type: (Check one)New ❑ Renewal ❑ Amendment ❑ Effective Date July 1,2015 Approved by Board YesX <br /> No❑ Agenda Date: June 16,2015 <br /> This agreement is approved as to techni�p1 f rm pnd content: <br /> �ocuignedby: <br /> Department Director's Signature <br /> PA blti Date: 9/16/2015 <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:'' <br /> 11LL <br /> Office of the Risk Management Officer <br /> �,Sa (,bvvte& Date: 9/15/2015 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in th jdtVquired by the Local Government Budget and Fiscal Control Act: <br /> ����(�� 9/16/2015 <br /> Office of the Chief Financial Officer pm/,L �,"-"'D"nbvu Date: <br /> 232DFFC2CFA847B... <br /> Legal Services <br /> This agreement is approved as to leggy sufficiency: <br /> Office of the County Attorney Date: 9/17/2015 <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 /> (Community Empowerment Fund) <br /> Orange County Outside Agency Performance Agreement Page 6 of 7 <br /> Rev. 6115 <br />