2020-870-E Aging - Charles House outside agency agreement

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DocuSign Envelope ID:2F348727-C96D-44CB-A423-F12561FB250C ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Charles House Association Party/Vendor Contact Person: Paul Klever Contact Phone: 919-967- 7570 Party/Vendor Address:7511 Sunrise Road City Chapel Hill State: NC Zip: 27514 Department: Finance & Administrative Services Amount:23,363 Purpose: FY 2020-21 Outside Agency/Human Services Performance Agreeement Budget Code(s): 10495050-710029 Vendor#vendor) 19446 Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one)New Renewal x❑ Amendment ❑ Effective Date 7/1/2020 Approved by Board Yes®No❑ Agenda Date: This agreement is approved as to techm ^ Vaff 'ontent: jav & ' �b_r 11/4/2020 Department Director's Signature Bz��s2oa_aFasaF�_. Date: Information Technoloizies (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 sufficiency of'nsa w4weWandards,specifications,and requirements: aUSA, rbvvu,TTb 11/5/2020 Office of the Risk Management Officer Date: Financial Services This instrument has been pre-audited in wamisottwoquired by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer � a Date: 11/5/2020 Legal Services This agreement is approved as to F"Off":sufficiency: r_�, Office of the County Attorney Date: 11/5/2020 Clerk to the Board Received for record retention: All Docusign contracts must be copied to Sherri Ingersoll upon completion @ singersoll&oran e�ync.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: (aAgencys_Name») Orange County Outside Agency Performance Agreement Page 7 of 9 Rev. 7118