HomeMy WebLinkAboutR 2016-630-E Finance - Charles House Association - Outside Agency Performance Agreement DocuSign Envelope ID:78F84828-4CC5-4A5B-B256-33C571A84687
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Charles House Association Party/Vendor Contact Person: Paul Klever Contact Phone: 919-
967-7570 Party/Vendor Address: 7511 Sunrise Road City Chapel Hill State: NC Zip: 27514 Department: Finance
&Administrative Services Amount: 20000 Purpose: Outside Agencies Finding Budget Code(s): 10495050-710029
Vendor# 800031 (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 igned by:
Department Director's Signature 9 Date:
Information Technologies
(Applicahle only to hardwarelsoftware 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 insura P"&q l�,bgpecifications, and requirements:
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Office of the Risk Management Officer 7FDCF917RRnn498 Date:
Financial Services
This instrument has been pre-audited in the manner r imo& -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 su74414, 4—"F gned 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 @ Dolloydgoran eg countync. oovv
The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board Date:
(Charles House Association)
Orange County Outside Agency Performance Agreement
Rev. 8116