HomeMy WebLinkAboutR 2016-647-E Finance - Table - Outside Agency Performance Agreement DocuSign Envelope ID:B32F3E9F-996A-4000-8CAF-83514F2E5759
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: TABLE Party/Vendor Contact Person: Ashton Tiepins Contact Phone: 919-636-4860
Party/Vendor Address: 205 West Weaver Street City Carrboro State: NC Zip: 27510 Department: Finance &
Administrative Services Amount: 5000 Purpose: Outside Agencies Funding Budget Code(s): 10495050-720116
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 forma KdTRfftft ed by:
0.&& 11/9/2016
Department Director's Signature Date:
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 insur (A"i specifications,and requirements:
EAF791105004 so, (hnut l6 11/11/2016
Office of the Risk Management Officer a � Date:
Financial Services
This instrument has been pre-audited in the manner ce iire�sbgytle li��Local Government Budget and Fiscal Control Act:
16.&
Office of the Chief Financial Officer oaa,ncc1aos... Date: 11/9/2016
Legal Services
This agreement is approved as to legal form and @4ey i� ed by:
11/11/2016
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 @ Dollo,d a oran eg countyne. 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:
(TABLE)
Orange County Outside Agency Performance Agreement
Rev. 8116