HomeMy WebLinkAboutR 2016-284-E Health - Empowerment, Inc. to provide career explorers program to designated youth DocuSign Envelope ID:276E5C1E-2398-4C5A-BAC3-4D588BFC7983
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Empowerment,Inc.Party/Vendor Contact Person: Sairta Nwachukwu Contact Phone: 919-967-
8779 Party/Vendor Address: 109 N. Graham Street #200 City Chapel Hill State: NC Zip: 27516 Department:
Health Amount: $25,000Purpose: Provide Career Explorers program to designated youth Budget Code(s):
10412020-681000-71453 Vendor # 39185 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No
Contract Type: (Check one)New® Renewal X Amendment ❑ Effective Date 5-25-16 Approved by Board Yes
❑No❑ Agenda Date:
This agreement is approved as to to '�at�gW qnd content:
(hu a, t ` 5/23/2016
Department Director's Signature Date:
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Information Technolo0es
(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 /are„standards,specifications,and requirements:
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Office of the Risk Management Officer (O�6 Date: 5/24/2016
Financial Services
This instrument has been pre-audited i TieftWKY P6rluired by the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer � C?q Date: 6/2/2016
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Legal Services
This agreement is approved as tq17gffTCfflffffdaWjd sufficiency:
Office of the County Attorney Date: 6/3/2016
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloydkorangecount.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:
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