HomeMy WebLinkAboutR 2016-632-E Finance - Community Empowerment Fund - Outside Agency Performance Agreement DocuSign Envelope ID:BF9F1016-CEDB-4BF6-9DF2-A6DAB623164C
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Community Empowerment Fund Party/Vendor Contact Person: Maggie West Contact Phone:
919-200-0233 Party/Vendor Address: 208 N. Columbia Street, Suite 100 City Chapel Hill State: NC Zip: 27514
Department:Finance&Administrative Services Amount: 7500 Purpose: Outside Agencies Funding Budget Code(s):
10495050-719064 Vendor#61695 (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 fted by:
Department Director's Signature Date:
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Information Technologies
(Applicable 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 insuran Z t d�pccifcations,and requirements:
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Office of the Risk Management Officer 7FDCF9176800498 Date:
Financial Services
This instrument has been pre-audited in the manner egt4l Vd' t 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 1�Y�Yed 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 @ Dolloyd&orangecountync.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:
(Community Empowerment Fund)
Orange County Outside Agency Performance Agreement
Rev. 8116