R 2018-450 Finance - Table outside agency agreement

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DocuSign Envelope ID: 2AC82140 -8F6C- 4125 - 8743- OB8594E61466 ORANGE COUNTY — DEPARTMENT USE ONLY Department Party/Vendor Name: TABLE Party/Vendor Contact Person: Ashton Tippins Contact Phone: 919 - 636 -4860 Party/Vendor Address: 209 East Main Street City Carrboro State: NC Zip: 27510 Department: Finance & Administrative Services Amount: 10450 Purpose: FY 2018 -19 Outside Agency /Human Services Performance Agreeement Budget Code(s): 10495050- 720116 Vendor # 800791 (N /A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 7/1/2018 Approved by Board Yes[] No❑ Agenda Date: 6/19/2018 This agreement is approved as to technical fo Docusigned by: 1 std 8/16/2018 Department Director's Signature 7NE5181ACC140g... Date: Information Technologies (Applicable only to hardware /software purchases or related services) This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer Risk Management Date: This agreement is approved for sufficiency of insui QocuSigned ay: fications, and requirements: 17MCF9176800498. 6L �,4Vln.t& 8/17/2018 Office of the Risk Management Officer . Date: Financial Services This instrument has been pre- audited in the mannf oocusigned ay: 3overnment Budget and Fiscal Control Act: 8/16/2018 Office of the Chief Financial Officer Date: 7oaE51s1acc,aas_. Legal Services This agreement is approved as to legal form OocuSigned dy: 8/17/2018 Office of the County Attorney 4035CB8304CA4Ae... Date: Clerk to the Board Received for record retention: All Docusign contracts must be copied to Sherri Ingersoll upon completion @ sin erg sollgoran eg countync. og_v The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board Date: (TABLE) Orange County Outside Agency Performance Agreement Page 6 of 9 Rev. 7118