HomeMy WebLinkAboutR 2015-408-E Finance - Charles House Association - 2015-16 Outside Agency Performance Agreement DocuSign Envelope ID:ADF76E75-8A91-4F91-BD39-9EB44F59669A
ORANGE COUNTY-DEPARTMENT USE ONLY
Deuartment
Party/Vendor Name: Charles House Association Party/Vendor Contact Person: Paul Klever Contact Phone: 919-
967-7570 Party/Vendor Address: 109 Hillcrest Avenue City Carrboro State: NC Zip: 27510 Department: Finance
& Adm. Srv. Amount:$ 15,000 Purpose: Outside Agency Performance Agreement Budget Code(s): 10495050
710029 Vendor 4 800031 (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 techni gd,vAp.ontent:
Department Director's Signature I pm/,L t,a+bvu Date: $/5/2015
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 sufficiency of insurance standards,specifications,and requirements:
DocuSigned""by:
''11
QllStU (6vvt,&b 8/5/2015
Office of the Risk Management Officer Date:
7FDCF9176800498...
Financial Services
This instrument has been pre-audited in the pagneerdrbyquired by the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer
m Date: 8/5/2015
232DFFC2CFA847B...
Legal Services
This agreement is approved as to legal f ryypp and ufficiency:
�ocu�igned Uy:
Office of the County Attorney F4jd WIj— Date: 8/5/2015
4035CB8304CA4A9...
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ DolloydLvorangecoul Utne.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:
(Charles House Association)
Orange County Outside Agency Performance Agreement Page 6 of 7
Rev. 6115