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DocuSign Envelope ID:43AE855E-F337-42FD-9D72-E26B8322A5F5 <br /> ORANGE COUNTY---DEPARTMENT USE ONLY---HARD COPY ONLY <br /> Department <br /> Party/Vendor Name: Qra <br /> ng!,- ount Schools PartyiVendor Contact Person: Sherita E. Cobb Contact Phone: 919- <br /> 245-4109 Party/Vendor Address: 1.914 New Hope Church Rd City Chapel Hill State: NC Zip: 27514 <br /> Department: DSS Amount: — Purpose: Provide a teen parent social worker to do case management services for <br /> pre ant and parenting teens in Vendor 4 <br /> _gjnL_ Budget Code(s): — (N/A if <br /> new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one)New F-1 Renewal F� <br /> Amendment ❑ Effective Date 07/01/16 Approved by Board YesEl NoF Agenda Date: <br /> This agreement is approved as to technical form ar-,, tiVed by: <br /> Department Director's Signature N4� 666vu Date. <br /> 84 5 <br /> Information Technologies, <br /> (Applicable only to hardwarelsqfi4,are 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 insu76"o" and requirements: <br /> a�Office of Risk Management Date: 8/31/2016 <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: DocuSigned by: <br /> Office of the Chief Financial Officer -N 0..&. Date: 9/19/2016 <br /> De 409 <br /> Legal Services <br /> This agreement is approved as to legal form and stiff Signed by: <br /> Office of the County Attorney Date: 9/20/2016 <br /> Clerk to the Board <br /> Received for record retention: <br /> Office of the Clerk to the Board Date: <br /> Revised 6/16 <br />