R 2016-284-E Health - Empowerment, Inc. to provide career explorers program to designated youth

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DocuSign Envelope ID:276E5C1E-2398-4C5A-BAC3-4D588BFC7983 ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Empowerment,Inc.Party/Vendor Contact Person: Sairta Nwachukwu Contact Phone: 919-967- 8779 Party/Vendor Address: 109 N. Graham Street #200 City Chapel Hill State: NC Zip: 27516 Department: Health Amount: $25,000Purpose: Provide Career Explorers program to designated youth Budget Code(s): 10412020-681000-71453 Vendor # 39185 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one)New® Renewal X Amendment ❑ Effective Date 5-25-16 Approved by Board Yes ❑No❑ Agenda Date: This agreement is approved as to to '�at�gW qnd content: (hu a, t ` 5/23/2016 Department Director's Signature Date: E9ED9B9FC�R5�46E... Information Technolo0es (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 sufficient /are„standards,specifications,and requirements: Q USA. , Office of the Risk Management Officer (O�6 Date: 5/24/2016 Financial Services This instrument has been pre-audited i TieftWKY P6rluired by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer � C?q Date: 6/2/2016 �n4F51 R�ncr.�an4-- Legal Services This agreement is approved as tq17gffTCfflffffdaWjd sufficiency: Office of the County Attorney Date: 6/3/2016 Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloydkorangecount.nic.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: Page 6 of 6 Revised 512016