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DocuSign Envelope ID: BDDDD430-E4C8-4429-B240-4E14BF7C5CC7 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: NC Coalition to End Homelessness (NCCEH) Party/Vendor Contact Person: Denise <br /> Neunaber [mailto:deniseAncceh.or Contact Phone: 919-755-4393 Party/Vendor Address: PO Box 27692 <br /> City Raleigh State: NC Zip: 27611 Department: County Manager - Homeless Programs Amount: FY18-19: <br /> $18,451 and FY19-20: $22,000.00 = Total $40,451 Purpose: HMIS database mana eg ment Budget Code(s): <br /> 32470620 630000 Vendor# (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: <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 l v W Atmj�1, Date: 6/20/2019 <br /> Agreements for emergency services or repair a no aAre 3E81a12e364a4 . 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 sufficiency of insurance standards,specifications,and requirements: <br /> DocuSigned <br /> _by: <br /> .�t <br /> Office of the Risk Management Officer aUsa (,6Vln.t,{�6 Date 9/10/2019 <br /> 7FDCF9176900498. <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: <br /> DocuSigned by: <br /> Office of the Chief Financial Officer <br /> s�gx.wra Date: 9/11/2019 <br /> 7NE5181ACC1409. <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: <br /> Office of the County Attorney , 66A, K6�C '6 Date:9/11/2019 <br /> EAAM33ED8AM65.. <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 /> 9 <br />