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DocuSign Envelope ID:C225CBFC-BC74-450D-8FD7-99E8F2A23E98 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Carolina Outreach, LLC Party/Vendor Contact Person: Holly Duggan Contact Phone: 919- <br /> 251-9001 Party/Vendor Address: 2670 Durham-Cha el Hill Blvd. City Durham State: NC Zip: 27707 <br /> Department: Social Services Amount: $30,000 Purpose: co-located therapist Budget Code(s): 10400220-761005 <br /> Vendor#59359 (NIA if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type:(Check one) <br /> New ® Renewal ❑ Amendment ❑ Effective Date 3/8/2019 Approved by Board Yes❑No❑ Agenda <br /> Date: <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work <br /> on this project has not been initiated prior to execution of the agreement: <br /> DocuSigned by: <br /> NOUN Ct� (hs bv, 3/21/2019 <br /> Department Director's Signature D,4€1F1A...1 9 Date: <br /> Agreements for emergency services or repair are not subject to the above affirmation. If services related to this <br /> agreement have already begun or been completed please briefly describe the nature of the emergency condition that <br /> was addressed: <br /> Information Technologies <br /> (Applicable only to hardwarelsoftware 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 Date: <br /> Risk Management <br /> This agreement is approved for sufficienc daa g`wtuystandards,specifications, and requirements: <br /> Q�1Sa C,bvvi t llb 3/13/2019 <br /> Office of the Risk Management Officer saoeasa Date: <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: DocuSigned by: <br /> 4� 3/25/2019 <br /> Office of the Chief Financial Officer t'D4Es,s1ACE14-0 ... Date: <br /> Legal Services <br /> This agreement is approved as to(ft&pqA!1fte1Jbd sufficiency: <br /> Office of the County Attorney ` Date 3/28/2019 <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@orangecountyne.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 /> Revised 12/18 <br /> 8 <br />