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DocuSign Envelope ID: B0FE06B7-7OC7-44D2-A46C-D41E904EED9B <br /> DHHS Contract Approval Form Division DAAS PO# 2190041659 <br /> Effective 3/12/18 <br /> (revised 3.12.2020) OW Contract#41659 <br /> Contractor Name: Orange County ESSS#lClick or tap here to enter text <br /> Contractor Type: local Government <br /> Federal Tax ID or SSN #56-60000327 Contract Title.Coronavirus Relief Funds <br /> Group#06 Service Name: CRF <br /> DUNSM 91545191 Contracts Dates: 3/1/2020 to 12/31/2020 <br /> Contract Administrator: Caitlin Fenhagen Amended Contract Dates:(Click or tap to enter a date,;to 1click <br /> Email: cfenhagen@orangecountync.gov Telephone: 919-245- or tap to enter a date; <br /> 2302 Contractor Signature Authority: Caitlin Fenhagen Contract Type: I®I FA or101 POS <br /> Contract Purpose: CRF Funding to providers to strategically Status: New Amd#IClick or tap here to enter text.( <br /> respond to COVID-19 and end homelessness in North <br /> Sub Contract No HIPAA BAA: No <br /> Carolina. <br /> IT Contract No How Procured RFA <br /> Rid#)Q ! pIAXQV�Is <br /> Contract Total Value 9 ,f 00, <br /> Joseph M. Breen X53435 <br /> Division Contract Administrator Telephone Amendment Amount: . <br /> New Contract Total Value: �' 195,000 <br /> 10/16/2020 <br /> Budget Officer Signature Date <br /> UII` Ilpl41C [ <br /> f® Funds Budgeted ID1 Funds Proposed <br /> [Ell Funds Proposed requires realignment BR# <br /> _Joseph M. Breen <br /> Section Chief Signature Date Budget&Analysis, if IT contract Date <br /> r2rRet�'e �a<ycue$� fct`o�en 1g, 2020 PIO Signature, if required Date <br /> Contract Manager/Office Signature Date <br /> HR Director Signature (required for Services)Date <br /> Division HR Signature, if required Date <br /> DHHS ITD Signature, if required Date <br /> Division ISO Signature, if required Date <br /> 0/20/20 OPCS Final Approval Signature Date <br /> Diyl lon Ulxecfor S rlat a Date <br /> ................ OPCS Tracking# <br /> EXBoutQa y <br /> Revised 3.12.20 <br />