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DocuSign Envelope ID:6F4743BF-4EA0-4961-AF93-D6509976FC9A <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> P /Vendor Name: Refugee Community Partnership Pa /Vendor Contact Person: Madison Hayes Contact Phone: <br /> Party/Vendor �: tv p Party/Vendor <br /> 919-740-5795 Party/Vendor Address: 117 W Main St. City: Carrboro State: NC Zip: 27510 Department: Human <br /> Rights&Relations Amount: $3,000.00 Purpose: Budget Code(s): Vendor#800679 (N/A if new vendor) Vendor is <br /> a BOCC consultant? Yes❑No❑ Contract Type:(Check one)New❑ Renewal❑ Amendment ❑ Effective Date <br /> Approved by Board Yes❑No❑ Agenda Date: July 1,2020 to June 30,2021 <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 /> DocuSignepd�by: <br /> Department Director's Signature '\ Date: 4/22/2021 <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 /> j <br /> Information Technolosies <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 /> i <br /> Risk Management <br /> This agreement is approved for sufficiency of insuranc -6Wspecifications,and requirements: <br /> Q�tSa CbV1n t{�b 4/26/2021 <br /> Office of the Risk Management Officer 8 Date: <br /> Financial Services <br /> This instrument has been pre-audited in the manner requ' "8nL%E Government Budget and Fiscal Control Act: <br /> el-N '�`�" °'� 4/26/2021 <br /> Office of the Chief Financial Officer Date: <br /> Legal Services <br /> This agreement is approved as to legal form and suffici Docusigned by: <br /> 7Q79A4D525GGF4FR <br /> ikv- A yif, SCD 4/26/2021 <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 /> Orange County Outside Agency Performance Agreement Page 6 of 9 <br /> Rev. 1121 <br />