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DocuSign Envelope ID: D2CB2439-4B3B-42E7-A090-286FDDD6E948 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Human Rights Center of Chapel Hill&Canboro Party/Vendor Contact Person: Kevin Noonan <br /> Contact Phone: 919-295-0570 Party/Vendor Address: 115 West Main Street, Suite #2G City Carrboro State: NC <br /> Zip: 27510 Department: Finance & Administrative Services Amount: 2000 Purpose: Outside Agencies Funding <br /> Budget Code(s): 10495050-719059 Vendor#62069 (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 an coRfffij`.gned by: <br /> Lita <br /> Department Director's Signature4R,A ,4Q 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 7stau!dusa, yspecifications,and requirements: <br /> COV'lnd 6 <br /> Office of the Risk Management Officer Date: <br /> Financial Services <br /> This instrument has been pre-audited in the manne7 ;ft 8tfeyd the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer Date: <br /> �B&Er1S40 CS 1409... <br /> Legal Services <br /> This agreement is approved as to legal form and su 1CCllGy gned by: <br /> Office of the County Attorney 035CE8'3 cA4a9 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.gov <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 /> (Human Rights Center of Chapel Hill&Carrboro) <br /> Orange County Outside Agency Performance Agreement <br /> Rev. 8116 <br />