HomeMy WebLinkAboutR 2015-438-E Finance - Human Rights Center of Chapel Hill & Carrboro - 2015-16 Outside Agency Performance Agreement DocuSign Envelope ID: 716FBOE9-5CE9-44F5-9BAC-48D7E4C96CD6
ORANGE COUNTY—DEPARTMENT USE ONLY
Deuartment
Party/Vendor Name: Human Rights Center of Chapel Hill & Carrboro Party/Vendor Contact Person: Asif Khan
Contact Phone: 919590-5980 Party/Vendor Address: 109 N. Graham Street City Chapel Hill State: NC Zip: 27516
Department: Finance & Adm. Srv. Amount:$ 1,000 Purpose: Outside Agency Performance Agreement Budget
Code(s): 10495050 719059 Vendor 4 62069 (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 gj.t9 AAgd content:
�
���(�� 8/13/2015
Department Director's Signature �A t"-"'D"�bvu Date:
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 ipsig�ne�""bst''al1nLdards,specifications,and requirements:
Office of the Risk Management Officer aUs& (,bvvu,ttb Date: 8/13/2015
7FDCF9176800498...
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
DocuSigned by:
Office of the Chief Financial Officer
bVu Date: 8/13/2015
232DFFC2CFA847B...
Legal Services
This agreement is approved a to le alpfo� na �ysufficiency:
8/13/2015
Office of the County Attorney ✓ Date:
4035CB8304CA4A9...
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ DolloyLyorangecou 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:
(Human Rights Center of Chapel Hill& Carrboro)
Orange County Outside Agency Performance Agreement Page 6 of 7
Rev. 6115