HomeMy WebLinkAboutR 2016-597-E Finance - Orange Congregations in Mission - Samaritan Relief Ministry - Outside Agency Performance Agreement DocuSign Envelope ID:A3E0213B-1DCD-43A3-9C41-A2EC55A8CA94
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Orange Congregations in Mission-Samaritan Relief Ministry Party/Vendor Contact Person:
Rev. Sharon S. Freeland Contact Phone: (919) 732-6194 x10 Party/Vendor Address: 300 Millstone Drive City
Hillsborough State: NC Zip: 27278 Department: Finance & Administrative Services Amount: 33415 Purpose:
Outside Agencies Funding Budget Code(s): 10495050-710031 Vendor# 800010 (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 forma cdR"ft_.ned by:
Department Director's Signature 4R,A ,4� 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 g4md wdsy-specifications,and requirements:
Qusa. CV'lnd O 6
Office of the Risk Management Officer 71MCE91268004g� Date:
Financial Services
This instrument has been pre-audited in the manner r IW�Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer � Date:
n.CCa ar�4
Legal Services
This agreement is approved as to legal form and su ' -DooGsigned by:
ff
Office of the County Attorney 4�,q 4,_ Date:
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloydkorangecount.ny_c.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:
(Orange Congregations in Mission-Samaritan Relief Ministry)
Orange County Outside Agency Performance Agreement
Rev. 8116