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DocuSign Envelope ID:3C5A2744-D635-47D4-8E91-68273BC0AA70 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Chapel Hill Carrboro Human Rights Center d.b.a. Refugee Community Partnership <br /> Party/Vendor Contact Person: Madison Hayes Contact Phone: 919-590-5910 Party/Vendor Address: PO Box 461 <br /> City Carrboro State: NC Zip: 27510 Department: Health Amount: $14,120 Purpose: Refugee support services <br /> Budget Code(s): Social Justice Funds Vendor# 800679 (N/A if new vendor) Vendor is a BOCC consultant? Yes <br /> ❑ <br /> No Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date 4-4-17 Approved by <br /> Board Yes No Agenda Date: 4-4-17 <br /> This agreement is approved as to techn tilidtd content: <br /> 'on t,I t 4/26/2017 <br /> Department Director's Signature 5145A2CD945G OF. Date: <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 sufficienc . sllfgtt :standards,specifications,and requirements: <br /> LtiS1 rbYlAVtO 4/26/2017 <br /> Office of the Risk Management Office 7FDCF9176800498... Date: <br /> Financial Services <br /> This instrument has been pre-audited i t eDrna iffier itquired by the Local Government Budget and Fiscal Control Act: <br /> � ` rt '`°` 5/4/2017 <br /> Office of the Chief Financial Officer 7D4E5181ACC1409... Date: <br /> Legal Services <br /> D c Si nedb <br /> This agreement is approved as t le aP fo and suffciency: <br /> tt '1' 1' �bSCb 5/5/2017 <br /> Office of the County Attorney 079A4D525C0F4FB... Date: <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd @orangecountync.gov <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 /> Refugee Community Partnership <br /> Orange County Outside Agency Performance Agreement—Social Justice Funds Page 6 of 7 <br /> April 2017 <br />