R 2016-618-E Finance - Habitat for Humanity, Orange County, NC, Inc. - Outside Agency Performance Agreement

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DocuSign Envelope ID:A65EF081-BF54-47AC-9969-94226D3FBC7E ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Habitat for Humanity, Orange County, NC, Inc. Party/Vendor Contact Person: Susan Lew Contact Phone: (919) 932-7077 Party/Vendor Address: 88 Vilcom Center Drive, Suite L110 City Chapel Hill State: NC Zip: 27514 Department: Finance & Administrative Services Amount: 25000 Purpose: Outside Agencies Funding Budget Code(s): 10495050-710023 Vendor # 800020 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No❑ Contract Type: (Check one)New❑ Renewal❑ Amendment ❑ Effective Date 7/1/16 Approved by Board Yes®No❑ Agenda Date: 6/21/16 This agreement is approved as to technical form S bed by: Department Director's Signature Date: 81 ACC1409... Information Technolo0es (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer Date: Risk Management This agreement is approved for sufficiency of insuran ��specifications,and requirements: gusa. (hV�t tff6 Office of the Risk Management Officer Date: �FDC-F9146890498... Financial Services This instrument has been pre-audited in the manner eqt et " e. Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer 4 81ACC14 Date: Legal Services This agreement is approved as to legal form and su C17cuSigned by: �Y� Office of the County Attorney Date: Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloydkorangecount.nic.gov The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board Date: (Habitat for Humanity, Orange County,NC Inc) Orange County Outside Agency Performance Agreement Rev. 8116