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DocuSign Envelope ID:6DC1ED22-B276-4193-B1F9-548B6AFFC7C5 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: EmPOWERment,Inc. Party/Vendor Contact Person: Delores Bailey Contact Phone: (919)-967-8779 <br /> Party/Vendor Address: 109 Graham St. City Chapel Hill State:NC Zip: 27516 Department: Housing&Community <br /> Development Amount: $66,900.75 Purpose: Mobile Home Relocation Coordination Services Budget Code(s): 61370035- <br /> 802200-10056 Vendor#N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check <br /> one) New ® Renewal ❑ Amendment ❑ Effective Date March 11, 2020 Approved by Board Yes® No❑ <br /> Agenda Date:March 20,2018 <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this <br /> project has not been initiated prior to execution of the agreement: <br /> Docusigned by: <br /> ►t SV&W 3/18/2020 <br /> Department Director's Signature Da2ea75CF42E4D7... Date: <br /> Agreements for emergency services or repair are not subject to the above affirmation.If services related to this agreement have <br /> already begun or been completed please briefly describe the nature of the emergency condition that was addressed: <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is approved as to <br /> information technology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficiency17FDCF9176800498 <br /> �ocusignea by: Is,specifications,and requirements: <br /> Usa �,DVIn.�,{f 6 3/26/2020 <br /> Office of the Risk Management Officer .. Date: <br /> Financial Services <br /> This instrument has been pre-audited it*1'ooeusigned by: 1` the Local Government Budget and Fiscal Control Act: <br /> 3/29/2020 <br /> Office of the Chief Financial Office Date: <br /> 704E5981ACC1469... <br /> Legal Services <br /> This agreement is approved as to 1P 1 f-- and C„Moip"O". <br /> OocuSigned by: <br /> �WAk ftp,{r{I, �S(h 3/30/2020 <br /> _Office of the County Attorney Date: <br /> 079A4D525C0F4Fg... <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 h, - ooc6signed by: s not required for Docusign contracts: <br /> 4/7/2020 <br /> Office of the Clerk to the Board_ DSC2A.Ec 91ss4sc... Date: <br /> Revised 12/18 <br />