Orange County NC Website
Browse       Search
DocuSign Envelope ID:987EC3F6-E183-4CB2-9D96-063C8A864FOC <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 PartyNendor Address: 2670 Durham-Chapel Hill Blvd. City Durham State: NC Zip: 27707 <br /> Department: Social Services Amount: $60,000 Purpose: co-located therapist Budget Code(s): 10400220-761005 <br /> Vendor#59359 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type: (Check one) <br /> New ® Renewal ❑ Amendment [J Effective Date 7/1/2019 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 /> OacuSigned by: <br /> N� �65{bw 7/19/2019 <br /> Department Director's Signature pAE1E198A83B455 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 oocu5ignea 6y: '-rds,specifications,and requirements: <br /> QU56 (,4V'IA.t 6 7/16/2019 <br /> Office of the Risk Management Office Date: <br /> 7F©CF917E800498. <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: oocusigned by: <br /> A.&I. 7/19/2019 <br /> Office of the Chief Financial Officer ` o4 a1ACC1409. Date: <br /> Legal Services <br /> This agreement is approved as t OocuSigned by: icy: <br /> Office of the County Attorne -4C35C68304CA4A9 h�8' Date:7/19/2019 <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts roust 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 /> 9 <br />