Orange County NC Website
Browse       Search
(El Centro Hispano, Inc.) <br />Orange County Outside Agency Performance Agreement Page 6 of 9 <br />Rev. 7/18 <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br />Department <br /> <br />Party/Vendor Name: El Centro Hispano, Inc. Party/Vendor Contact Person: Pilar Rocha-Goldberg Contact Phone: <br />919-687-4635, x43 Party/Vendor Address: 2000 Chapel Hill Road, Suite 26A City Durham State: NC Zip: 27707 <br />Department: Finance & Administrative Services Amount: 32834 Purpose: FY 2018-19 Outside Agency/Human <br />Services Performance Agreeement Budget Code(s): 10495050-719058 Vendor # 801399 (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 /> <br />This agreement is approved as to technical form and content: <br /> <br />Department Director’s Signature ________________________________________ Date: ________ <br /> <br /> <br />Information Technologies <br /> <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 /> <br />Office of the Chief Information Officer___________________________________ Date: ________ <br /> <br /> <br />Risk Management <br /> <br />This agreement is approved for sufficiency of insurance standards, specifications, and requirements: <br /> <br />Office of the Risk Management Officer___________________________________ Date: _________ <br /> <br /> <br />Financial Services <br /> <br />This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> <br />Office of the Chief Financial Officer ____________________________________ Date: _________ <br /> <br /> <br />Legal Services <br /> <br />This agreement is approved as to legal form and sufficiency: <br /> <br />Office of the County Attorney __________________________________________Date: ________ <br /> <br /> <br />Clerk to the Board <br /> <br />Received for record retention: <br />All Docusign contracts must be copied to Sherri Ingersoll upon completion @ singersoll@orangecountync.gov <br /> <br />The following signature block is for hard copies only and is not required for Docusign contracts: <br /> <br /> <br />Office of the Clerk to the Board __________________________________________Date:_________ <br /> <br />DocuSign Envelope ID: A899BE5E-BAEC-40F3-91E1-A9D77FC4C488 <br /> <br /> <br /> <br />