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DocuSign Envelope ID:6B6EBA29-C8D4-4113-B4DC-CEAE3FB1 14B7 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: UNCH Party/Vendor Contact Person: JI Campbell Contact Phone: (919) 966-7029 <br /> Party/Vendor Address: 101 Mannino Dr City, Chapel Hill State: NC Zip: 27514 Department: DSS Amount: <br /> S42 587 Purpose: Provide one full time IMC worker and Budget Code(s): <br /> 10403005-442311 Vendor <br /> (N/A if new vendor) Vendor is a BOCC consultant? Yes F-I No[] Contract <br /> Type: (Check one) New ❑ Renewal M Amendment 0 Effective Date 07/0.,11'16 Approved by Board YesE <br /> No❑ Agenda Date: <br /> This agreement is approved as to technical form an 'igned by: <br /> Department Director's Signature _ N" 666vu Date: 8/22/2016 <br /> tED'XE1_E_1_9_6_K8:TS_45 <br /> Information Technologies <br /> (Applicable only to harchvarels((hvare purchases or related services)This agreement has been reviewed and is <br /> approved as to information technology content and specifications: <br /> Office of the Director of Information Technology--.—,--,. Date: <br /> Risk Management <br /> This agreement is approved for sufficiency of insur P,;o�st&, specifications,and requirements: <br /> Office of Risk Management 7/7/2016 <br /> EME9_17BBDjM_qa__ Date: <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: ed by: <br /> Office of the Chief Financial Officer 8/22/2016 <br /> _f Date: <br /> Le aal Services <br /> This agreement is approved as to legal form and SL <br /> Office of the County Attorney Date: 8/23/2016 <br /> Clerk to the Board <br /> Received for record retention: <br /> Office of the Clerk to the Board —Date:—, <br />