R 2016-645-E Finance - Boomerang Youth, Inc. - Outside Agency Performance Agreement

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DocuSign Envelope ID: B701CF6A-1C9A-46CB-9234-56F771D80955 ORANGE COUNTY-DEPARTMENT USE ONLY Department Party/Vendor Name: Boomerang Youth, Inc. Party/Vendor Contact Person: Sonia Frischemeier Contact Phone: 919-442-9622 Party/Vendor Address: 825A N. Estes Drive City Chapel Hill State: NC Zip: 27514 Department: Finance & Administrative Services Amount: 10,000 Purpose: Outside Agencies Funding Budget Code(s): 10495050-719047 Vendor# 800750 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑Nor-1 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 forma Wf& !ed by: Department Director's Signature t� nnG�, Date: 11/9/2016 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 insur /sta�i ; s ecifications,and requirements: QUSA. r,0b 11/11/2016 Office of the Risk Management Officer �FOCFS,�ssoo4g8... Date: Financial Services This instrument has been pre-audited in the manner qu4ffffty fi aFS�g�nrr�anq t Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer C � n Date: 11/9/2016 n Legal Services This agreement is approved as to legal form and suf deigned by: ,T saves 11/11/2016 Office of the County Attorney gp3SrRn�nar D 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: (Boomerang Youth,Inc) Orange County Outside Agency Performance Agreement Rev. 8116