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Revised 07/20 9 <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br />Party/Vendor Name: OCHCD Party/Vendor Contact Person: Emila Sutton Contact Phone: (919)- 245-2490 <br />Party/Vendor Address: 300 W Tryon St City Hillsborough State: NC Zip: 27278 Department: OCHCD Amount: <br />$341,633 Purpose: ESG-CV Budget Code(s): OCHCD-32470605 442235 95040 Emergency Solutions Grant <br />Funds $(140,816); CJRD 30212005 442235 95040 EMERGENCY SOLUTIONS GRANT FNDS $(115,409); <br />32470605-442235-95040 Emergency Solutions Grant Funds- RRH ($85,408) Vendor # N/A (N/A if new <br />vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal <br />Amendment Effective Date 07/29/20 Approved by Board Yes No Agenda Date: 07/15/2020 <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 />Department Director’s Signature ________________________________________ 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: N/A <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 of insurance standards, specifications, and requirements: <br />Office of the Risk Management Officer___________________________________ 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: <br />Office of the Chief Financial Officer ____________________________________ Date: _________ <br />Legal Services <br />This agreement is approved as to legal form and sufficiency: <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 />DocuSign Envelope ID: A3F0C410-E465-42A4-AE07-78C4B90F42A5 <br />11/30/2020 <br />11/30/2020 <br />12/1/2020 <br />12/1/2020