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DocuSign Envelope ID: F396A7D5-62F3-4B5B-A968-F49AA5397EFF <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: EmPOWERment,Inc. Party/Vendor Contact Person: Delores Bailey Contact Phone: 919 <br /> 967-8779 Party/Vendor Address: 109 N. Graham Street, Suite 200 City Chapel Hill State: NC Zip: 27516 <br /> Department:H&CD Amount: $145,000 Purpose:Acquisition Activities Budget Code(s): 32473020-789005-47318 <br /> Vendor# (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one) <br /> New ® Renewal ❑ Amendment ❑ Effective Date July 22„ 2019 Approved by Board Yes® No❑ <br /> Agenda Date: June 19,2018 <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 /> Department Director's Signature_ - Date:7/14/2019 <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: N/A <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 sufficienc, _Qocusigned by: ds,specifications,and requirements: <br /> Qusa. �,DVlnk& 7/31/2019 <br /> Office of the Risk Management Officer 7MCF917Esoo4ss. 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 /> Aw 8/1/2019 <br /> Office of the Chief Financial Officer Date: <br /> - 704E51S1ACC1409. <br /> Legal Services <br /> This agreement is approved as to DocuSigned by: <br /> 8/1/2019 <br /> Office of the County Attorney_1 079A4D525C0F4FB. 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 />