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1 <br /> DocuSign Envelope ID:AB039DC1-8309-4D41-B525-6E84F973FAA6 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: The Exchange Club's Family Center in Alamance Party/Vendor Contact Person: George <br /> Bryan Contact Phone: 336-748-9028 Party/Vendor Address: 200 N. Main Street City: Graham State: NC Zip: <br /> 27253 Department: Social Services Amount: $6,175 Purpose: Outside Agency Performance Agreement Budget <br /> Code(s): 10400120-630000 Vendor 62677 (N/A if new vendor) Vendor is a BOCC consultant? Yes No X <br /> Contract Type: (Check one)New Lii Renewal E Amendment E Effective Date July 1, 2016 Approved by Board <br /> Yes X NoE] Agenda Date: June 16, 2016 <br /> This agreement is approved as to technical form and irisigned by: <br /> NUAttl £4StOtA, 2/10/2017 <br /> Department Director's Signature Date: <br /> BAH El-96 A13313455 <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is <br /> approved as to information technology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficiency of insuranc .14EiefrigaVvcifications,and requirements: <br /> tiSO CartAki-to <br /> 2/1/2017 <br /> Office of the Risk Management Officer__ Date: <br /> 7 FD6R,9-1-76812■0498 <br /> Financial Services <br /> This instrument has been pre-audited in the manner re ireB0br€EVI!),25Cal Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer Date: 2/10/2017 <br /> 7 D4E5184ACC1401:4 <br /> Legal Services <br /> This agreement is approved as to legal form and suff ket!Signed by: <br /> Office of the County Attorney 40.4._ <br /> ate: 2/15/2017 <br /> 4035C00304CA4A9- D <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Polloyckik)samecountynccov <br /> The following signature block is for hard copies only and is not required for Docusign contracts: <br /> Office of the Clerk to the Board Date: <br /> rrhe`E.xchange Cluk's I anvly Ce?Yer i?"1410M ) <br /> Orange County Outside Agency Performance Agreement <br /> Rev. 8/16 <br />