HomeMy WebLinkAboutR 2015-531-E Finance - Planned Parenthood South Atlantic - 2015-16 Outside Agency Performance Agreement DocuSign Envelope ID:935E5DF2-2E44-4828-901E-8C6C6A7DFAE8
ORANGE COUNTY-DEPARTMENT USE ONLY
Deuartment
Party/Vendor Name: Planned Parenthood South Atlantic Party/Vendor Contact Person: Doug Jackson, Interim
President and CEO Contact Phone: 919-833-7534 x251 Party/Vendor Address: 1765 Dobbins Drive City Chapel
Hill State: NC Zip: 27514 Department: Finance & Adm. Srv. Amount:$ 20,000 Purpose: Outside Agency
Performance Agreement Budget Code(s): 10495050 710013 Vendor 4 800040 (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&al12m and content:
ocu igne by:
9/29/2015
Department Director's Signatur blti Date:
Ci232DFFC2CFA847B
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:''11LL
Office of the Risk Management Officer rius. (,bvvt e& Date: 9/25/2015
7FDCF9176800498...
Financial Services
This instrument has been pre-audited in iNquired by the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer PMAL t'"-+bVu Date: 9/29/2015
232DFFC2CFA847B...
Legal Services
This agreement is approved a to le aU, fficiency:
Office of the County Attorney ✓ Date: 9/29/2015
4035CB8304CA4A9...
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd yorangecou 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:
(Planned Parenthood South Atlantic)
Orange County Outside Agency Performance Agreement Page 6 of 7
Rev. 6115