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DocuSign Envelope ID:7F6941BA-A8EF-47E6-80D8-B1F7F90D3351 <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 St, Ste 100 City Chapel Hill State: NC Zip: 27514 <br /> Department: Managers Office Amount: $10,000 Purpose: Coordinated Entry database maintenance and development <br /> Budget Code(s): 32470620 630000 Vendor# (N/A if new vendor) Vendor is a BOCC consultant? Yes <br /> ❑ <br /> No Contract Type: (Check one)New® Renewal❑ Amendment ❑ Effective Date 11/1/2016 Approved by <br /> Board Yes No Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> DocuSigned by: <br /> Department Director's Signature tP'aW-(S kruA, Date:11/28/2017 <br /> 0A3E81B12B364B4... <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 insurance standards, specifications, and requirements: <br /> r----DocuSigned""by: <br /> ''��.. <br /> Office of the Risk Management Officer QUSa (/'ortA c o Date: 11/29/2017 <br /> `'*• 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> ,---DocuSigned by: <br /> Office of the Chief Financial Officer Date:11/29/2017-7D4E5181 ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> r----DocuSigned by: <br /> j <br /> Office of the County Attorney o rott5 Date: 11/29/2017 <br /> �—EAA3D33ED8A8465... <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 /> Revised 2/17 5 <br />