HomeMy WebLinkAboutR 2016-618-E Finance - Habitat for Humanity, Orange County, NC, Inc. - Outside Agency Performance Agreement DocuSign Envelope ID:A65EF081-BF54-47AC-9969-94226D3FBC7E
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Habitat for Humanity, Orange County, NC, Inc. Party/Vendor Contact Person: Susan Lew
Contact Phone: (919) 932-7077 Party/Vendor Address: 88 Vilcom Center Drive, Suite L110 City Chapel Hill State:
NC Zip: 27514 Department: Finance & Administrative Services Amount: 25000 Purpose: Outside Agencies
Funding Budget Code(s): 10495050-710023 Vendor # 800020 (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 S bed by:
Department Director's Signature Date:
81 ACC1409...
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 insuran ��specifications,and requirements:
gusa. (hV�t tff6
Office of the Risk Management Officer Date:
�FDC-F9146890498...
Financial Services
This instrument has been pre-audited in the manner eqt et " e. Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer 4 81ACC14 Date:
Legal Services
This agreement is approved as to legal form and su C17cuSigned by:
�Y�
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.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:
(Habitat for Humanity, Orange County,NC Inc)
Orange County Outside Agency Performance Agreement
Rev. 8116