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DocuSign Envelope ID: 80124B29- E4DA- 4BOD- A879- D287FCF3F3CA <br />ORANGE COUNTY — DEPARTMENT USE ONLY <br />Department <br />Party/Vendor Name: Refugee Support Center Party/Vendor Contact Person: Flicka Bateman Contact Phone: 919- <br />423 -1478 Party/Vendor Address: PO Box 1025 City Carrboro State: NC Zip: 27510 Department: Finance & <br />Administrative Services Amount: 5000 Purpose: FY 2018 -19 Outside Agency/Human Services Performance <br />Agreeement Budget Code(s): 10495050- 720276 Vendor # 800468 (N /A if new vendor) Vendor is a BOCC <br />consultant? Yes ❑ No❑ Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date <br />7/1/2018 Approved by Board Yes® No❑ Agenda Date: 6/19/2018 <br />This agreement is approved as to technical fo Docusigned by: <br />8/16/2018 <br />Department Director's Signature ` o4E5181ACC1409 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 <br />Date: <br />Risk Management <br />This agreement is approved for sufficiency of it Docu5igned by: )eclficatlons, and requirements: <br />aUS& �,bV1n.t,{�6 8/17/2018 <br />Office of the Risk Management Officer 7FDCF917E80049s... Date: <br />Financial Services <br />This instrument has been pre- audited in the DocuSigned by: )cal Government Budget and Fiscal Control Act: <br />8/16/2018 <br />Office of the Chief Financial Officer 7NE5181ACC1409... Date: <br />Legal Services <br />This agreement is approved as to legal form and Oocusigned by: <br />Office of the County Attorney 4035CB8 A4 Date. <br />8 /17/2018 <br />4�35C68304CA4A�... <br />Clerk to the Board <br />Received for record retention: <br />All Docusign contracts must be copied to Sherri Ingersoll upon completion @ sin erg sollgoran eg countync.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 />(Refugee Support Center) <br />Orange County Outside Agency Performance Agreement Page 6 of 9 <br />Rev. 7118 <br />