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Revised 06/21 <br />9 <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br /> <br />Party/Vendor Name: Community Empowerment Fund Party/Vendor Contact Person: Ari Rosenberg Contact Phone: <br />919-200-0233 Party/Vendor Address: 208 N. Columbia St, Suite 100 City Chapel Hill State: NC Zip: 27514 <br />Department: OCHCD Amount: $7,944.20 Purpose: database management Budget Code(s): 32470620 630000 <br />Vendor # (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) <br />New Renewal Amendment Effective Date 07/01/2022 Approved by Board Yes No Agenda Date: <br /> --- For Section XIV. c. contracts only, Approved by Board in Current FY 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: Community Empowerment Fund provided database management for a county-wide resource <br />database in FY21-22. The need for this work continued into FY22-23 to ensure smooth operations for the network of <br />homeless service providers in Orange County. <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 /> <br /> <br /> <br /> <br />DocuSign Envelope ID: 03EFAAE3-12D0-425E-A3F2-F8CD6A526107 <br />11/2/2022 <br />11/2/2022 <br />11/4/2022 <br />11/4/2022