HomeMy WebLinkAboutR 2016-629-E Finance - Boys & Girls Club of Eastern Piedmont - Outside Agency Performance Agreement DocuSign Envelope ID:2164F437-BF9D-46A1-B13B-7740B02003DA
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Boys& Girls Club of Eastern Piedmont Party/Vendor Contact Person: Sarah Marion Contact
Phone: 919-663-6159 Party/Vendor Address: 288 East Street, Suite 1008 City Pittsboro State: NC Zip: 27312
Department:Finance&Administrative Services Amount: 5000 Purpose: Outside Agencies Funding Budget Code(s):
- Vendor# (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 fo MA"tby:
Department Director's Signature re, Date: 11/3/2016
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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 sufficiency of insur /sta�i ; s ecifications,and requirements:
QUSA. r,0b 11/4/2016
Office of the Risk Management Officer �FOCFS,�ssoo4s8... Date:
Financial Services
This instrument has been pre-audited in the manner r 'fL&0j9nt MyLocal Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer 7 Date: 11/3/2016
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Legal Services
This agreement is approved as to legal form and s CL�";ed by:�� 11/4/2016
Office of the County Attorney �a� D 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:
(Boys &Girls Club of Eastern Piedmont)
Orange County Outside Agency Performance Agreement
Rev. 8116