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DocuSign Envelope ID:FCA96EA6-6080-4E8E-8EFF-B03ECA597827 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Boys & Girls Club of Durham & Orange Counties Party/Vendor Contact Person: Jerome <br /> Levisy Contact Phone: 919-687-4517 Party/Vendor Address: 808 East Pettigrew Street; PO BOX 446 City Durham <br /> State: NC Zip: 27702 Department: Finance&Administrative Services Amount: 6500 Purpose:FY 2017-18 Outside <br /> Agency Performance Agreement Budget Code(s): 10695050719055 Vendor /1 800171 (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ <br /> Effective Date 7/1/2017 Approved by Board Yes No Agenda Date: 6/20/2017 <br /> This agreement is approved as to technical 4P1 2�filent: <br /> 10/10/2017 <br /> Department Director's Signature �E5181ACc14og... 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 i eigii,anjlards,specifications,and requirements: <br /> MSA. rbvvutl6 10/12/2017 <br /> Office of the Risk Management Officer Date: <br /> $rDCrons8004D8... <br /> Financial Services <br /> DocuSig d by: <br /> This instrument has been pre-audited in the mann r requ of bx t hee Local Government Budget and Fiscal Control Act: <br /> �,LlJJ 10/10/2017 <br /> Office of the Chief Financial Officer 7D4E5181ACC1409... Date: <br /> Legal Services <br /> This agreement is approved as to lega or11:7 �M1iciency: <br /> ate, (ULrit, 1 SCo 10/12/2017 <br /> Office of the County Attorney m�n48G2 CO Date: <br /> FB... <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 /> (Boys&Girls Club of Durham &Orange Counties) <br /> Orange County Outside Agency Performance Agreement Page 7 of 10 <br /> Rev. 7/17 <br />