R 2016-633-E Finance - EmPOWERment, Inc. - Outside Agency Performance Agreement

Browse Search

DocuSign Envelope ID:4FOB7605-OOEB-4D90-837E-574BBBBD89EB ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: EmPOWERment, Inc. Party/Vendor Contact Person: Delores Bailey Contact Phone: 919967- 8779 Party/Vendor Address: 109 N. Graham Street, Suite 200 City Chapel Hill State: NC Zip: 27516 Department: Finance &Administrative Services Amount: 25000 Purpose: Outside Agencies Funding Budget Code(s): 10495050- 789005 Vendor# 800065 (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 for WC0iurtV*: Department Director's Signature Date: eaee9ze ... 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 ins ur d�;specifications,and requirements: a�iSa CbV1n,f✓N Office of the Risk Management Officer Fee Date: Financial Services This instrument has been pre-audited in the manner egt4l Vd' t Local Government Budget and Fiscal Control Act: 16. Office of the Chief Financial Officer ffi Date: Legal Services hjT This agreement is approved as to legal form and suf Icle 'gnea by: Office of the County Attorney L� 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: (EmPOWERment,Inc.) Orange County Outside Agency Per/ormance Agreement Rev. 8116