R 2016-630-E Finance - Charles House Association - Outside Agency Performance Agreement

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DocuSign Envelope ID:78F84828-4CC5-4A5B-B256-33C571A84687 ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Charles House Association Party/Vendor Contact Person: Paul Klever Contact Phone: 919- 967-7570 Party/Vendor Address: 7511 Sunrise Road City Chapel Hill State: NC Zip: 27514 Department: Finance &Administrative Services Amount: 20000 Purpose: Outside Agencies Finding Budget Code(s): 10495050-710029 Vendor# 800031 (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 an igned by: Department Director's Signature 9 Date: Information Technologies (Applicahle only to hardwarelsoftware 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 insura P"&q l�,bgpecifications, and requirements: ,Uso, (hnvh Office of the Risk Management Officer 7FDCF917RRnn498 Date: Financial Services This instrument has been pre-audited in the manner r imo& -Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer Date: Legal Services This agreement is approved as to legal form and su74414, 4—"F gned by: � 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 @ Dolloydgoran eg countync. oovv The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board Date: (Charles House Association) Orange County Outside Agency Performance Agreement Rev. 8116