HomeMy WebLinkAboutR 2016-209-E Health - Chapel Hill-Carrboro YMCA-Boomerang - program support resources students living in or attending a zone school DocuSign Envelope ID: DB07BCBB-97D7-4769-AF8A-905711BEFAD9
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Chapel Hill-Carrboro YMCA-Boomerang Party/Vendor Contact Person: Tami Pfeifer Contact
Phone: 919-968-2146 Party/Vendor Address: 825-A North Estes Drive City Chapel Hill State: NC Zip: 27516
Department: Health Amount: $10.000 Purpose: Program support resources for Boomerang to provide services to
students living in or attending a zone school. Budget Code(s): 10412020-681000-71453 Vendor#800057 (N/A if new
vendor) Vendor is a BOCC consultant? Yes ❑ No[] Contract Type: (Check one) New ® Renewal ❑
Amendment ❑ Effective Date 1-1-2016 Approved by Board Yes F]No❑ Agenda Date:
This agreement is approved as to to n cliff&& f$�YYi,d1,A,c ment:
Imo` 4/12/2016 UkVA�
Department Director's Signature�QF�oonF�s�s�s-. Date:
Information Technolosies
(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 I� ®rstandards, specifications,and requirements:
QUSA, (hVVt 6 4/12/2016
Office of the Risk Management Officer ,,s,,,-7-,,,,4, Date:
Financial Services
This instrument has been pre-audited i gft8fYWVftquired by the Local Government Budget and Fiscal Control Act:
a€�asa Teo.
Office of the Chief Financial Officer
i t a Date: 4/15/2016
..
Legal Services
This agreement is approved as t eg°a4`l'b"'ffiYd sufficiency:
Office of the County Attorney Date: 4/15/2016
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloy(d c�orangecount.nic.gov
The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board Date:
Revised 1/16 4