HomeMy WebLinkAboutR 2016-603-E Finance - Human Rights Center of Chapel Hill & Carrboro - Outside Agency Performance Agreement DocuSign Envelope ID: D2CB2439-4B3B-42E7-A090-286FDDD6E948
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Human Rights Center of Chapel Hill&Canboro Party/Vendor Contact Person: Kevin Noonan
Contact Phone: 919-295-0570 Party/Vendor Address: 115 West Main Street, Suite #2G City Carrboro State: NC
Zip: 27510 Department: Finance & Administrative Services Amount: 2000 Purpose: Outside Agencies Funding
Budget Code(s): 10495050-719059 Vendor#62069 (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 an coRfffij`.gned by:
Lita
Department Director's Signature4R,A ,4Q 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 7stau!dusa, yspecifications,and requirements:
COV'lnd 6
Office of the Risk Management Officer Date:
Financial Services
This instrument has been pre-audited in the manne7 ;ft 8tfeyd the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer Date:
�B&Er1S40 CS 1409...
Legal Services
This agreement is approved as to legal form and su 1CCllGy gned by:
Office of the County Attorney 035CE8'3 cA4a9 Date:
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:
(Human Rights Center of Chapel Hill&Carrboro)
Orange County Outside Agency Performance Agreement
Rev. 8116