R 2016-396-E Health - Freedom House to provide Zone 4 Navigator Services

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DocuSign Envelope ID:F6D4D28D-1 E29-4905-AB38-673A41 131371`34 ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Freedom House Party/Vendor Contact Person: Patricia Hussey Contact Phone: 919-942-8083 Party/Vendor Address: 104 New Stateside Drive City Chapel Hill State: NC Zip: 27516 Department: Health Amount: $57,893 Purpose: Provide Zone 4 Navigator Services Budget Code(s): 10414020-681000-71453 Vendor# 34104 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New Renewal❑ Amendment ❑ Effective Date 7/1/16 Approved by Board Yes❑No❑ Agenda Date: This agreement is approved as to to n c°3F`Y�ff hfid c ntent: � � 7/11/2016 Department Director's Signature G Fa Date: 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 sufficienc 4 t �_�ys'taandards,specifications,and requirements: aLtSA rbvvutl6 7/11/2016 Office of the Risk Management Officer. Ga17raoo4aa Date: Financial Services This instrument has been pre-audited iWtfxPmWPm#"quired by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer Date: 7/22/2016 Legal Services This agreement is approved as t e a� o in Ad sufficiency: � -�4� 7/22/2016 Office of the County Attorney 4o35ce83o4cA4AS... Date: Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd&oran eg countync.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 612016