HomeMy WebLinkAboutR 2017-160-E Health - El Centro Hispano - Outside Agency Performance Agreement DocuSign Envelope ID:917E7596-F2F2-4BF8-B6C3-DDO5E1503A51
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: El Centro Hispano Party/Vendor Contact Person: Filar Rocha-Goldberg Contact Phone: 919-
687-4635 Party/Vendor Address: 2000 Chapel Hill Road, Suite 26A City Durham State: NC Zip: 27707
Department: Health Amount: $54,168 Purpose: Immigrant support services Budget Code(s): Social Justice Funds
Vendor# 801399 (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 to c? F d content:
LOtU15/1/2017
Department Director's Signature 5143A9mg45/140E 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 . lAgaric 's'taandards,specifications,and requirements:
[ itUs . rbvvutl6 5/2/2017
Office of the Risk Management Officer 7FDCF9176800498... Date:
Financial Services
This instrument has been pre-audited i e 4fl` 1 @�dquired by the Local Government Budget and Fiscal Control Act:
� p `�°" o°"` 5/11/2017
Office of the Chief Financial Officer ,D4E51$14Cp1 Q9 Date:
Legal Services
This agreement is approved as t e Th??fid$Y�id.-�suf iciency:
&A 1' Aunt, a 5/11/2017
Office of the County Attorney 070A411595c0F4FR 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