HomeMy WebLinkAboutR 2016-582-E Finance - Freedom House Recovery Center, Inc. - Outside Agency Performance Agreement DocuSign Envelope ID:636AFD33-DA5C-4B55-88DC-03C0863BAFE3
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Freedom House Recovery Center, Inc. Party/Vendor Contact Person: Patricia E. Hussev
Contact Phone: 919-942-2803 Party/Vendor Address: 104 New Stateside Drive City Chapel Hill State: NC Zip:
27516 Department: Finance & Administrative Services Amount: 35,000 Purpose: Outside Agencies Funding
Budget Code(s): 10495050-710037 Vendor# 800030 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑
No❑ Contract Type: (Check one)New® Renewal❑ Amendment ❑ Effective Date 7/1/16 Approved by Board
Yes®No❑ Agenda Date: 6/21/16
This agreement is approved as to technical form "fftjqf�by.
Department Director's Signature ('� Date:
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 sufficiency of insur stmifllv&: specifications,and requirements:
7a so` COV'ln,t,{fb
Office of the Risk Management Officer ,FE91268nnagR Date:
Financial Services
This instrument has been pre-audited in the manner uR,6d"eft:Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer Date:
Legal Services
This agreement is approved as to legal form and suf cfellignea by:
Office of the County Attorney Date:
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloydkorangecount.nic.Rov
The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board Date:
(Freedom House Recovery Center,Inc)
Orange County Outside Agency Performance Agreement
Rev. 8116