Orange County NC Website
DocuSign Envelope ID: 2AC82140 -8F6C- 4125 - 8743- OB8594E61466 <br />ORANGE COUNTY — DEPARTMENT USE ONLY <br />Department <br />Party/Vendor Name: TABLE Party/Vendor Contact Person: Ashton Tippins Contact Phone: 919 - 636 -4860 <br />Party/Vendor Address: 209 East Main Street City Carrboro State: NC Zip: 27510 Department: Finance & <br />Administrative Services Amount: 10450 Purpose: FY 2018 -19 Outside Agency /Human Services Performance <br />Agreeement Budget Code(s): 10495050- 720116 Vendor # 800791 (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 />1 std 8/16/2018 <br />Department Director's Signature 7NE5181ACC140g... 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 />Risk Management <br />Date: <br />This agreement is approved for sufficiency of insui QocuSigned ay: fications, and requirements: <br />17MCF9176800498. 6L �,4Vln.t& 8/17/2018 <br />Office of the Risk Management Officer . Date: <br />Financial Services <br />This instrument has been pre- audited in the mannf oocusigned ay: 3overnment Budget and Fiscal Control Act: <br />8/16/2018 <br />Office of the Chief Financial Officer Date: <br />7oaE51s1acc,aas_. <br />Legal Services <br />This agreement is approved as to legal form OocuSigned dy: <br />8/17/2018 <br />Office of the County Attorney 4035CB8304CA4Ae... Date: <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. og_v <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 />(TABLE) <br />Orange County Outside Agency Performance Agreement Page 6 of 9 <br />Rev. 7118 <br />