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DocuSign Envelope ID:6F373526-8608-47C8-AA9D-FDDD57D0834F <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: AHB Center for Behavioral Health and Wellness Party/Vendor Contact Person: April Harris <br /> Britt Contact Phone: 919-401-8090 Party/Vendor Address: 3326 Durham Chapel Hill Blvd. - Building_D City <br /> Durham State: NC Zip: 27707 Department: Social Services Amount: $13,500 Purpose: psychological <br /> evaluations/client therapy Budget Code(s): 10400220-761005/10405020-768000 Vendor # 62547 (N/A if new <br /> vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ <br /> Amendment ❑ Effective Date 7/l/2020 Approved by Board Yes[]No❑ Agenda Date: <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work <br /> on this project has not been initiated prior to execution of the agreement: <br /> DocuSigned by: <br /> Department Director's Signature NOUAU1 R,455vu Date: 1/20/2021 <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 sufficient &Baiagmaeystandards, specifications, and requirements: <br /> a�tSa C,bvvti,c,l(b 1/20/2021 <br /> Office of the Risk Management Officer FeeFr, Date: <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: DocuSigned by: <br /> (1� +� 1/21/2021 <br /> Office of the Chief Financial Office Date: <br /> Legal Services <br /> This agreement is approved as t 2H -atnd sufficiency: <br /> 1/25/2021 <br /> Office of the County Attorney Date: <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 /> Revised 07/20 <br /> 9 <br />