2021-048-E Social Svc-Art Therapy Institute Cardinal Managed Care agreement

Browse Search

DocuSign Envelope ID:8C3AC364-20A8-477A-92A7-8FBD4923E2D0 ORANGE COUNTY—DEPARTMENT USE ONLY Party/Vendor Name: Institute of Art Therapy DBA Art Therapy Institute Party/Vendor Contact Person: Bridget Pemberton-Smith Contact Phone: 919-605-2081 Party/Vendor Address: 200 N. Greensboro St., Suite D-6 City Carrboro State: NC Zip: 27510 Department: Social Services Amount: $31,477 Purpose: outside agency funds + Behavioral Health MOE Budget Code(s): 10420020-710050/10495050-720109 Vendor#63288 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New ❑ Renewal ® Amendment ❑ Effective Date 7/l/2020 Approved by Board Yes®Non Agenda Date: 6/16/2020 This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has not been initiated prior to execution of the agreement: DocuSigned by: Department Director's Signature ;UA.G. cbS�bin. Date: 112712021 Agreements for emergency services or repair are not subject to the above affirmation. If services related to this agreement have already begun or been completed please briefly describe the nature of the emergency condition that was addressed: Information Technologies (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer Date: Risk Management This agreement is approved for sufficienc i3�oystandards,specifications,and requirements: &A, cbvv�. N 112712021 Office of the Risk Management Officer ,,,F I,.- 198 Date: Financial Services This instrument has been pre-audited ' D"g2&4 equired by the Local Government Budget and Fiscal Control Act: ('b� 1/29/2021 Office of the Chief Financial Officer t-E=s-rar�e Date: Legal Services This agreement is approved as t t 2eYfd sufficiency: Office of the County Attorney ` Date; 1/29/2021 Clerk to the Board Received for record retention: All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountyne.gov The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board Date: &4gencys Name») Orange County Outside Agency Performance Agreement Page 8 Rev. 112021