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DocuSign Envelope ID: 5D25D6E0-7166-4244-AEA3-02E6A45FD852 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Community Empowerment Fund Party/Vendor Contact Person: Maggie West Contact Phone: <br /> 919-200-0233 Party/Vendor Address: 208 N. Columbia Street, Suite 100 City Chapel Hill State: NC Zip: 27514 <br /> Department:Finance &Administrative Services Amount: 13750 Purpose: FY 2017-18 Outside Agency Performance <br /> Agreement Budget Code(s): 10495050719064 Vendor # 61695 (N/A if new vendor) Vendor is a BOCC <br /> consultant? Yes ❑ No Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date <br /> 7/1/2017 Approved by Board Yes No Agenda Date: 6/20/2017 <br /> This agreement is approved as to technical orni `en nt: <br /> 00,4`/dia m. 8/31/2017 <br /> Department Director's Signature 7D4E5181ACC1409_, 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 sufficiency of insur Dsa KU' specifications,and requirements: <br /> QiSa c60 9/5/2017 <br /> Office of the Risk Management Officer 7FDCF9176800498... Date: <br /> Financial Services <br /> DocuSi d by: <br /> This instrument has been pre-audited in the ma er requu�en Q�@�the Local Government Budget and Fiscal Control Act: <br /> eqt-f6A "ox.4t i'"°. 8/31/2017 <br /> Office of the Chief Financial Officer 7D4E5181ACC1409. Date: <br /> Legal Services <br /> cuSi ned by: <br /> This agreement is approved as to legal form an s iciec <br /> ate, / A 1-MO 9/5/2017 <br /> Office of the County Attorney o79A4D525C0F4Fe_. 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 /> (Community Empowerment Fund) <br /> Orange County Outside Agency Performance Agreement Page 7 of 10 <br /> Rev. 7/17 <br />