R 2016-632-E Finance - Community Empowerment Fund - Outside Agency Performance Agreement

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DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Community Empowerment Fund Party/Vendor Contact Person: Maggie West Contact Phone: 919-200-0233 Party/Vendor Address: 208 N. Columbia Street, Suite 100 City Chapel Hill State: NC Zip: 27514 Department:Finance&Administrative Services Amount: 7500 Purpose: Outside Agencies Funding Budget Code(s): 10495050-719064 Vendor#61695 (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 fted by: Department Director's Signature Date: ea�1$1�eelze ... Information Technologies (Applicable 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 insuran Z t d�pccifcations,and requirements: aUso, (hnvh Office of the Risk Management Officer 7FDCF9176800498 Date: Financial Services This instrument has been pre-audited in the manner egt4l Vd' t 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 1�Y�Yed 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 @ Dolloyd&orangecountync.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: (Community Empowerment Fund) Orange County Outside Agency Performance Agreement Rev. 8116