Orange County NC Website
Revised 06/21 <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br /> <br />Party/Vendor Name: OC Rape Crisis Center Party/Vendor Contact Person: Oseye Laing Contact Phone: <br />Party/Vendor Address: 1506 E Franklin St City Chapel Hill State: NC Zip: 27515 Department: Finance & <br />Administrative Services Amount: $72,340.00 Purpose: Loan to Nonprofit per Budget Amendment Budget Code(s): <br />94940020-900400-94502 Vendor # 800015 (N/A if new vendor) Vendor is a BOCC consultant? Yes No <br />Contract Type: (Check one) New Renewal Amendment Effective Date 06/07/2022 Approved by Board <br />Yes No Agenda Date: 06/07/2022 --- For Section XIV. c. contracts only, Approved by Board in Current FY <br />Budget Yes No <br /> <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 /> <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: <br /> <br />Information Technologies <br /> <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 /> <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 />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: 18B266FC-5A76-4690-9B5F-188F47B4DEDD <br />6/15/2022 <br />6/15/2022 <br />6/16/2022