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Revised 07/20 <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br /> <br />Party/Vendor Name: OCHCD Party/Vendor Contact Person: E Sutton Contact Phone: 919-245-2490 Party/Vendor Address: <br />300 W Tryon St City Hillsborough State: NC Zip: 27278 Department: 4800 Amount: $195,000 Purpose: CARES (CRF)- <br />NCDHHS Budget Code(s): 32470620-782630-95051 Street Outreach $5000.00; 32470620-782631-95051 Essential Move-In <br />$57,163; 32470620-782632-95051 Homelessness Prevention $30,000.00; 32470620-782633-95051 Unit Upfits $15,000.00; <br />32470620-782634-95051 Hotel Assistance $14,000.00; 32470620-630315-95051 Landlord Incentives $50,000.00; 32470620 - <br />633300-95051 $4,500.00; 32470610-510000-95040 Permanent Salaries (RRH Case Manager) $19,337. Vendor # N/A (N/A <br />if new vendor) Vendor is a BOCC consultant? Yes X No Contract Type: (Check one) New Renewal Amendment <br />X Effective Date 10/01/20 Approved by Board Yes X No Agenda Date: 10/01/20 <br /> <br />This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this <br />project has not been initiated prior to execution of the agreement: <br /> <br /> <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 agreement <br />have already begun or been completed please briefly describe the nature of the emergency condition that was addressed: <br /> <br /> <br />Information Technologies <br /> <br />(Applicable only to hardware/software purchases or related services) This agreement has been reviewed and is approved as <br />to information technology content and specifications: <br /> <br />Office of the Chief Information Officer___________________________________ Date: ________ <br /> <br />Risk Management <br /> <br />This agreement is approved for sufficiency of insurance standards, specifications, and requirements: <br /> <br />Office of the Risk Management Officer___________________________________ Date: _________ <br /> <br />Financial Services <br /> <br />This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> <br />Office of the Chief Financial Officer ____________________________________ Date: _________ <br /> <br />Legal Services <br /> <br />This agreement is approved as to legal form and sufficiency: <br /> <br />Office of the County Attorney __________________________________________Date: ________ <br /> <br /> <br />Clerk to the Board <br /> <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 /> <br />Office of the Clerk to the Board __________________________________________Date:_________ <br />DocuSign Envelope ID: B0FE06B7-70C7-44D2-A46C-D41E904EED9B <br />11/11/2020 <br />11/11/2020 <br />11/11/2020 <br />11/11/2020 <br />DocuSign Envelope ID: A2458184-14A2-484C-86F8-D2AF007C2EA1DocuSign Envelope ID: 25D139D3-875C-4103-9918-BA012E00293F