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DocuSign Envelope ID:72266CE5-DF5A-471 E-B671-CC65C8960691 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: EmPOWERment, Inc. Party/Vendor Contact Person: Delores Bailey Contact Phone: <br /> 9199678779 Party/Vendor Address: 109 N. Graham Street, Suite 200 City Chapel Hill State: NC Zip: 27516 <br /> Department: Finance &Administrative Services Amount: 27500 Purpose: FY 2017-18 Outside Agency Performance <br /> Agreement Budget Code(s): 10495050789005 Vendor # 800065 (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 /> DocuSi n d by: <br /> This agreement is approved as to technic 1 form1'Pi f cspn <br /> Department Director's Signature 04E5181ACCCC1409... Date: 8/31/2017 <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 i Nfieteigtvitit4rds,specifications, and requirements: <br /> MSi. rbY1A,th 9/14/2017 <br /> Office of the Risk Management Officer 7FDCF9176800498... Date: <br /> Financial Services <br /> This instrument has been pre-audited in the man r retittearlythe Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Offceraa,nc-lanam Date: 8/31/2017 <br /> Legal Services <br /> This agreement is approved as to legal fo a12O'lzeehcy: <br /> t AAA . Aunt, <br /> 1 SCo 9/14/2017 <br /> Office of the County Attorney 079,gd1595(DEAER 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 /> (EmPOWERment,Inc.) <br /> Orange County Outside Agency Performance Agreement Page 7 of 10 <br /> Rev. 7/17 <br />