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HomeMy WebLinkAboutR 2017-151-E Health - Chapel Hill - Carrboro Human Rights Center dba Refugee Community Partnership - Outside Agency Performance Agreement DocuSign Envelope ID:3C5A2744-D635-47D4-8E91-68273BC0AA70 ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Chapel Hill Carrboro Human Rights Center d.b.a. Refugee Community Partnership Party/Vendor Contact Person: Madison Hayes Contact Phone: 919-590-5910 Party/Vendor Address: PO Box 461 City Carrboro State: NC Zip: 27510 Department: Health Amount: $14,120 Purpose: Refugee support services Budget Code(s): Social Justice Funds Vendor# 800679 (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 techn tilidtd content: 'on t,I t 4/26/2017 Department Director's Signature 5145A2CD945G OF. 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 sufficienc . sllfgtt :standards,specifications,and requirements: LtiS1 rbYlAVtO 4/26/2017 Office of the Risk Management Office 7FDCF9176800498... Date: Financial Services This instrument has been pre-audited i t eDrna iffier itquired by the Local Government Budget and Fiscal Control Act: � ` rt '`°` 5/4/2017 Office of the Chief Financial Officer 7D4E5181ACC1409... Date: Legal Services D c Si nedb This agreement is approved as t le aP fo and suffciency: tt '1' 1' �bSCb 5/5/2017 Office of the County Attorney 079A4D525C0F4FB... 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: Refugee Community Partnership Orange County Outside Agency Performance Agreement—Social Justice Funds Page 6 of 7 April 2017