HomeMy WebLinkAboutR 2016-645-E Finance - Boomerang Youth, Inc. - Outside Agency Performance Agreement DocuSign Envelope ID: B701CF6A-1C9A-46CB-9234-56F771D80955
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Boomerang Youth, Inc. Party/Vendor Contact Person: Sonia Frischemeier Contact Phone:
919-442-9622 Party/Vendor Address: 825A N. Estes Drive City Chapel Hill State: NC Zip: 27514 Department:
Finance & Administrative Services Amount: 10,000 Purpose: Outside Agencies Funding Budget Code(s):
10495050-719047 Vendor# 800750 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑Nor-1 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 forma Wf& !ed by:
Department Director's Signature t� nnG�, Date: 11/9/2016
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 11/11/2016
Office of the Risk Management Officer �FOCFS,�ssoo4g8... Date:
Financial Services
This instrument has been pre-audited in the manner qu4ffffty fi aFS�g�nrr�anq t Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer C � n Date: 11/9/2016
n
Legal Services
This agreement is approved as to legal form and suf deigned by:
,T saves 11/11/2016
Office of the County Attorney gp3SrRn�nar 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:
(Boomerang Youth,Inc)
Orange County Outside Agency Performance Agreement
Rev. 8116