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DocuSign Envelope ID: A2273A84- 8827 - 4141- A87E- C8CFF83C3936 <br />ORANGE COUNTY - DEPARTMENT USE ONLY <br />Department <br />Party/Vendor Name: Human Rights Center of Chapel Hill & Carrboro Party/Vendor Contact Person: Madison Hayes <br />Contact Phone: 919- 295 -0570 Party/Vendor Address: 117 West Main Street City Carrboro State: NC Zip: 27510 <br />Department: Finance & Administrative Services Amount: 10775 Purpose: FY 2018 -19 Outside Agency /Human <br />Services Performance Agreeement Budget Code(s): 10495050- 719059 Vendor # 62069 (N /A if new vendor) <br />Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ <br />Effective Date 7/1/2018 Approved by Board Yes® No❑ Agenda Date: 6/19/2018 <br />This agreement is approved as to technical forr DocuSigned by: <br />Department Director's Signature 4"zw,� Date: 8/23/2018 <br />704E5181ACC1409... <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 />This agreement is approved for sufficiency of insura DocuSigned by: <br />aCisa <br />Office of the Risk Management Officer 7FDCF917ES00498... <br />Financial Services <br />This instrument has been pre - audited in the ma oocu5igned by: <br />Office of the Chief Financial Officer 704E5181 <br />ACC1409... <br />]legal Services <br />This agreement is approved as to legal form an DocuSigned by: <br />Office of the County Attorney ` <br />4035C68304CA4 A4M... <br />Clerk to the Board <br />Date: <br />cations, and requirements: <br />Date: 8/24/2018 <br />al Government Budget and Fiscal Control Act: <br />8/23/2018 <br />Date: <br />8/24/2018 <br />Date: <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 />(Human Rights Center of Chapel Hill & Carrboro) <br />Orange County Outside Agency Performance Agreement Page 6 of 9 <br />Rev. 7118 <br />