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DocuSign Envelope ID:Dal 3694BA-66F1-4441-9114-5334F2B6AC3D <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Planned Parenthood South Atlantic Party/Vendor Contact Person: Jenny Black Contact Phone: <br /> 919-833-7526 x6140 Party/Vendor Address: 100 S Boylan Ave City Raleigh State: NC Zip: 27603 Department: <br /> Finance & Administrative Services Amount: 20000 Purpose: FY 2017-18 Outside Agency Performance Agreement <br /> Budget Code(s): 10495050710013 Vendor ft 800040 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ <br /> No Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 7/1/2017 Approved by <br /> Board Yes No Agenda Date: 6/20/2017 <br /> DocuSi n d by: <br /> This agreement is approved as to technic 1 f aPef c�pntent: <br /> (41.4. ,..,z 10/10/2017 <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 ins anBpcff '"� 'd�s,�specifications,and requirements: <br /> a�Sabvvt,t4Tb 11/13/2017 <br /> Office of the Risk Management Officer 7FDCF9176800498... Date: <br /> Financial Services <br /> This instrument has been pre-audited in the man er altffigeadMi the Local Government Budget and Fiscal Control Act: <br /> An ,,,,z 10/10/2017 <br /> Office of the Chief Financial Officer 7D4E5181ACC1409... Date: <br /> Legal Services <br /> This agreement is approved as to legal form an Eby <br /> ate, h let, 1).S(b 11/13/2017 <br /> Office of the County Attorney Date: <br /> -079A4DG2;C-@F4FB... <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 /> (Planned Parenthood South Atlantic) <br /> Orange County Outside Agency Performance Agreement Page 7 of 10 <br /> Rev. 7/17 <br />