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DocuSign Envelope ID:6BA9D3D1-719B-42F7-A645-83C9267F2082 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: State ESG Office Party/Vendor Contact Person:Lisa Worth Contact Phone: (919)-855-4993 <br /> Party/Vendor Address: 2101 Mail Service Center City Raleigh State: NC Zip: 27699 Department: OCHCD <br /> Amount: $303,365 Purpose: Rapid Re-Housing (RRH) Financial Assistance;Housing Stability Case Manager 1 <br /> FTE and Coordinated Entry Prevention/Diversion.5 FTE Budget Code(s): 32470605-4412 -9$000 Vendor#_ <br /> (N/A if nevE3endor) aendor is a BOCC consultant? Yes No ContrE Tyge <br /> (Check one)New Renewal ®Amendment Effective Date 4/l/2021 Approved by Board Yes No <br /> 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 /> 1� <br /> `�Wtl�G1 SWlbv, 3/22/2021 <br /> Department Director's Signature D42B075CF42E4D7... Date: <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 sufficiency ®mW!wecWnndards,specifications,and requirements: <br /> LaUS& rbvvu lib 3/22/2021 <br /> Office of the Risk Management Officer 7PQrPQ176AQWQQ 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 /> rq� �" `n 3/22/2021 <br /> Office of the Chief Financial Officer ,D4F51A1Arr.14M Date: <br /> Legal Services <br /> This agreement is approved as to sufficiency: <br /> Qkku� Auril, 'No 3/22/2021 <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 />