R 2016-356-E DSS - L.I.F.E. Skills Foundation for fostering youth opportunities

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DocuSign Envelope ID: 3D9A2C3C-B477-4E3B-886F-5583C52FF19A ORANGE COUNTY-DEPARTMENT USE ONLY Department Party/Vendor Name: L.I.F.E. Skills Foundation Party/Vendor Contact Person: Alex Protzman Contact Phone: 919-265-9667 Party/Vendor Address: 2670 Durham-Chgpel H.J.11 Blvd City Durham State: NC Zip: 27707 Department: Social Services Amount: $_17.000 Purpose: Fostering Youth Opportunities Budget Code(s): 30400220-630000-71091 Vendor 4' 57259 (N/A if new vendor) Vendor is a BOCC consultant? Yes El NoE Contract Type: (Check one) NewE] Renewal E Amendment F] Effective Date July 1_20j. Approved by Board YesR No[E Agenda Date: I'his agreement is approved as to technical forin a q@igned by: Department Director's Signature 666vu Date: 7/12/2016 _IAEI-E-1-�9�6AH 55 Information Technologie (Applicable only to hardivaralsofiware put-chases 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 Managemen This agreement is approved for sufficiency of insura ftM&Mg,bxpecifications,and requirements: gusa, (,6VVtff6 7/7/2016 Office of the Risk Management Officer ]7ZFDC�FR1tBBDDA9a_ Date: ------ Financial Services This instrument has been pre-audited in the mariner required by the Local Government Budget and Fiscal Control Act: EDocusigned by: Office of the Chief Financial Officer Date: 7/12/2016 Legal Services This agreement is approved as to legal form and Srif[7ri�ed by: Office of the County Attorney , 7/12/2016 —Date: ................... Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Floyd upon completion Ca.) [,jqj,[qy�j� The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board Date: Revised 6/16 _-_-------_-_--_--------------.............-___-__-_----------- ......................... --------____......