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DocuSign Envelope ID:44FOD66E-1905-4A6D-B2D2-D7CO2EDF751A <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: El Futuro, Inc. Party/Vendor Contact Person: Kerry Brock Contact Phone: 919-688-7101 <br /> x632 Party/Vendor Address: 136 E. Chapel Hill Street City Durham State: NC Zip: 27701 Department: Health <br /> Amount: $53,769 Purpose: Outpatient mental health and substance abuse treatment services Budget Code(s): <br /> 10414020-630000 Vendor#57915 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract <br /> Type: (Check one)New❑ Renewal ® Amendment ❑ Effective Date 7-1-19 Approved by Board Yes®No <br /> ❑ Agenda Date: 6-18-19 <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 /> S�.wo- 7/12/2019 <br /> Department Director's Signature 3C16F2D09E3445F. 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 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 Date: <br /> Risk Management <br /> This agreement is approved for sufficient �ocusigned by: rds,specifications,and requirements: <br /> SUS& " A6 7/15/2019 <br /> Office of the Risk Management Office 7FDCFs176s004,N. 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 /> A . 7/15/2019 <br /> Office of the Chief Financial Officer 7DaE5aa1ACC1409. Date: <br /> Legal Services <br /> This agreement is approved as DocuSigned by: <br /> §WAk fta�Vit' 1 7/15/2019 <br /> Office of the County Attorne 079MD525COF4FB. Date: <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@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 /> Revised 12/18 <br /> 8 <br />