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(The Arc of the Triangle) <br />Orange County Outside Agency Performance AgreementPage 7of 9 <br />Rev. 8/18 <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br />Department <br />Party/Vendor Name: The Arc of the Triangle Party/Vendor Contact Person: Jennifer Pfaltzgraff Contact Phone: <br />919-942-5119Party/Vendor Address: 1709 Legion Road, Suite 100City Chapel HillState: NCZip: 27514 <br />Department: Finance and Administrative ServicesAmount: 39,928Purpose: FY 2018-19 Outside Agency and Mental <br />Health Performance AgreementBudget Code(s): 10495050-719023Vendor # 50706(N/A if new vendor) Vendor <br />is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective <br />Date 7/1/2018Approved by Board Yes No Agenda Date: 6/19/2018 <br />This agreement is approved as to technical form and content: <br />Department Director’s Signature ________________________________________ 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 ChiefInformation Officer___________________________________ Date: ________ <br />Risk Management <br />This agreement is approved for sufficiency of insurance standards, specifications, and requirements: <br />Office of the Risk Management Officer___________________________________ Date: _________ <br />Financial Services <br />This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br />Office of the Chief Financial Officer ____________________________________ Date: _________ <br />Legal Services <br />This agreement is approved as to legal form and sufficiency: <br />Office of the County Attorney __________________________________________Date: ________ <br />Clerk to the Board <br />Received for record retention: <br />All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@orangecountync.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 />DocuSign Envelope ID: 9F461F1C-C86C-42DC-B78C-50FC18D204DF <br /> <br /> <br /> <br />