HomeMy WebLinkAboutR 2017-150-E Health - Refugee Support Center - Outside Agency Performance Agreement DocuSign Envelope ID:6661FF62-5F0B-4B97-9C2E-09BCC224B580
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Refugee Support Center Party/Vendor Contact Person: Flicka Bateman Contact Phone: 919-
423-1478 Party/Vendor Address: PO Box 1025 City Carrboro State: NC Zip: 27510 Department: Health Amount:
$11,340.00 Purpose: Refugee support services Budget Code(s): Social Justice Funds Vendor# 62967 (N/A if new
vendor) Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one) New ® Renewal ❑
Amendment ❑ Effective Date 4-4-17 Approved by Board Yes No Agenda Date:4-4-17
This agreement is approved as to t ° ' �i� e �d� �coQntent:
OV'0 UluVtZt 4/25/2017
Department Director's Signature 5145n2CD945c40F... Date:
Information Technologies
(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 sufficient d r e_eys'taandards,specifications,and requirements:
aMtSA. rbvvutl0 5/2/2017
Office of the Risk Management Officer Date:
�Feere17c5oo495...
Financial Services
This instrument has been pre-audited i r, oratlitnell'required by the Local Government Budget and Fiscal Control Act:
(71.4., ��n 5/4/2017
Office of the Chief Financial Officer ' Date:
Legal Services
This agreement is approved as t e crth'MY�ni`',,g�ii.i-�sufficiency:
'1' r` t1' SCb 5/5/2017
Office of the County Attorney 07Q4d1152FrOF4FR 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:
Orange County Outside Agency Performance Agreement—Social Justice Funds Page 6 of 7
April 2017