HomeMy WebLinkAboutR 2015-368-E Finance - Chapel Hill-Carrboro YMCA Boomerang - Outside Agency Performance Agreement DocuSign Envelope ID: 57FEBA8F-F3CB-4E27-8449-89742020C9FA
ORANGE COUNTY-DEPARTMENT USE ONLY
Deuartment
Party/Vendor Name: Chapel Hill-Carrboro YMCA- Boomerang Party/Vendor Contact Person: Kim Grooms
Contact Phone: 919-442-9622 Party/Vendor Address: 980 Martin Luther King Jr. Blvd. City Chapel Hill State: NC
Zip: 27514 Department: Finance & Adm. Srv. Amount:$ 5,000 Purpose: Outside Agency Performance Agreement
Budget Code(s): 10495050 719047 Vendor 4 800057 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑
NoX Contract Type: (Check one)New ❑ Renewal ❑ Amendment ❑ Effective Date July 1,2015 Approved by
Board YesX No❑ Agenda Date:June 16,2015
This agreement is approved as to tec ' b9n ,:content:
Department Director's Signature �,AIAbIn, Date: 7/28/2015
232DFFC2CFA847B...
Information Technologies
(Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is
approved as to information technology content and specifications:
Office of the Chief Information Officer Date:
Risk Management
This agreement is approved for sufficient �1,,7gys''t�1andards,specifications,and requirements:
Q�.SA. r,6vvt,e; 7/28/2015
Office of the Risk Management Officer F Date:
Financial Services
This instrument has been pre-audited in t M gAequired by the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer ' Date: 7/28/2015
232DFFC2CFA847B...
Legal Services
This agreement is approved as to legal form and sufficiency:
DOCUSigned by:
7/28/2015
Office of the County Attorney Date:
4035CB83046A4A9...
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ DolloydLvorm-1gecolintync.go v
The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board Date:
(Chapel Hill-Carrboro YMCA-Boomerang)
Orange County Outside Agency Performance Agreement Page 6 of 7
Rev. 6115