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DocuSign Envelope ID:636AFD33-DA5C-4B55-88DC-03C0863BAFE3 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Freedom House Recovery Center, Inc. Party/Vendor Contact Person: Patricia E. Hussev <br /> Contact Phone: 919-942-2803 Party/Vendor Address: 104 New Stateside Drive City Chapel Hill State: NC Zip: <br /> 27516 Department: Finance & Administrative Services Amount: 35,000 Purpose: Outside Agencies Funding <br /> Budget Code(s): 10495050-710037 Vendor# 800030 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑ <br /> No❑ Contract Type: (Check one)New® Renewal❑ Amendment ❑ Effective Date 7/1/16 Approved by Board <br /> Yes®No❑ Agenda Date: 6/21/16 <br /> This agreement is approved as to technical form "fftjqf�by. <br /> Department Director's Signature ('� Date: <br /> Information Technolo0es <br /> (Applicable only to hardware/software 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 insur stmifllv&: specifications,and requirements: <br /> 7a so` COV'ln,t,{fb <br /> Office of the Risk Management Officer ,FE91268nnagR Date: <br /> Financial Services <br /> This instrument has been pre-audited in the manner uR,6d"eft:Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer Date: <br /> Legal Services <br /> This agreement is approved as to legal form and suf cfellignea by: <br /> Office of the County Attorney Date: <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloydkorangecount.nic.Rov <br /> The following signature block is for hard copies only and is not required for Docusign contracts: <br /> Office of the Clerk to the Board Date: <br /> (Freedom House Recovery Center,Inc) <br /> Orange County Outside Agency Performance Agreement <br /> Rev. 8116 <br />