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DocuSign Envelope ID: ED6C5D54-7108-4169-9541-C2FDA3EC8CA6 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: OC Disability Awareness Council Party/Vendor Contact Person: Timothy Miles Contact <br /> Phone: 919-245-4337 Party/Vendor Address: 503 W. Franklin Street Room 113 City Chapel Hill State: NC Zip: <br /> 27516 Department: Finance &Administrative Services Amount: 7000 Purpose: Outside Agencies Funding Budget <br /> Code(s): 10495050-710032 Vendor# 800037 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ <br /> Contract Type: (Check one)New® Renewal❑ Amendment ❑ Effective Date 7/1/16 Approved by Board Yes <br /> ® <br /> Nor-1 Agenda Date: 6/21/16 <br /> This agreement is approved as to technical forma cftlillynea by: <br /> Department Director's Signature � Q <br /> p g R1 ACC1409 <br /> Date: <br /> r 7D4F51 <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 insuran away opecifications,and requirements: <br /> s a. COV'lnd 6 <br /> Office of the Risk Management Officer Date: <br /> Financial Services <br /> This instrument has been pre-audited in the manner r quW"WyLocal Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer 4 81ACC14 Date: <br /> Legal Services <br /> This agreement is approved as to legal form and suffi ' {i®cusignea by: <br /> Office of the County Attorney 4�,q 4,_ 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 /> (OC Disability Awareness Council) <br /> Orange County Outside Agency Performance Agreement <br /> Rev. 8116 <br />