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000vSign Envelope ID: eAoE4Cnr-70er-4uo0~^88E-o4081eE40eCA Contract#68-2009 <br /> Charles House Association <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Charles House Association Purh/Vuodor Contact Person: Paul Klevor Contact Phone: (919) 967-7570 <br /> Party/Vendor Address: 7511 Sunrise Rd. City Chapel Hill State: NC Zip: 27514 Department: Social Services Amount: $25`000 <br /> Purpose: Adult D Care Budget Code(s): 10405020-764100 Vendor# l0446 if new vendor) Vendor is a BOCC consultant? <br /> Yes nEl Contract Type:(Check one)New 0 Renewal Amendment [l Effective Date July |.2817 Approved by Board },co <br /> [lY4oN Agenda Date: <br /> This agreement is approved as to te niniuMn Mid content: <br /> NttlAbi ��h. <br /> �� ' 7/21/2017 <br /> Department Director's Sigou1ucc\^_"^s,s,yv^o»e+o,— Date: <br /> Information Technologies <br /> (Applicable only to ha purchases or related services)This agr ement has been reviewed and is approved as to <br /> information technology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> Thiuug,eemeu1iouyp,ovedKxxuf�ciou urdx'xyeci�umtinno, and requ�cnuertu: <br /> Ett,~'~ u`' ^~°`` 7/ZO/ZOl7 <br /> ��MUcunf the Biimk0�unagemeut��tDoe *oo,y//000v^oo Date: <br /> . Financial Services <br /> This instrument has been pre-audited in Vivaitiverdliequired 6 the Local Government Budget and Fiscal Control Act: <br /> | /21+t. A��/��� 7/21/2017 <br /> ��8Oc*of the��hbxf Financial Officer [ °' Date: <br /> +uwa*m/w*-1409- <br /> Legal Services <br /> Thixu�eomm4isupproved sufficiency: <br /> �mm~ 7/21/2017 <br /> K»yOccu[the oComu1y/kttormcy\._4v,xca^3o^cAw^» Date: <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ DolloydAorangecountync.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 /> Contract-General (07/10) Page 5 of 5 <br />