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DocuSign Envelope ID: D90F57Fl-8076-4358-9941-F62552053F84 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Chapel Hill Outreach Project,Inc.DBA KidSCope Party/Vendor Contact Person: Term+David <br /> Contact Phone: 919-644-6590 Party/Vendor Address: 101 Cloister Court, Suite D City Chapel Hill State: NC Zip: <br /> 27514 Department: Social Services Amount: $90,000 Purpose: outside agency funds + Behavioral Health MOE <br /> Budget Code(s): 10420020-710050/10495050-710015 Vendor# 800060 (N/A if new vendor) Vendor is a BOCC <br /> consultant? Yes❑No® Contract Type:(Check one)New❑ Renewal® Amendment ❑ Effective Date 7/1/2020 <br /> Approved by Board Yes®No❑ Agenda Date: 6/16/2020 <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work on <br /> this project has not been initiated prior to execution of the agreement: <br /> DocuSigned by: <br /> Department Director's Signature NOUAU1 (him, Date: 112712021 <br /> Agreements for emergency services or repair are not subject to the above 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 sufficienc ddb�»r gstandards,specifications, and requirements: <br /> Q�Sa / / <br /> Office of the Risk Management Officer 1,oV�tb Date: 1 26 2021 <br /> Financial Services <br /> This instrument has been pre-audited' R%m"oequired by the Local Government Budget and Fiscal Control Act: <br /> +� 2/1/2021 <br /> Office of the Chief Financial Officer Date: <br /> Legal Services <br /> This agreement is approved as t cffl%ffdaitl'd sufficiency: <br /> Office of the County Attorney Date:2/8/2021 <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@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 /> ((Mgencys_Name») <br /> Orange County Outside Agency Performance Agreement Page 8 <br /> Rev. 112021 <br />