HomeMy WebLinkAboutR 2017-288-E Health - Freedom House - Outside Agency Performance Agreement DocuSign Envelope ID:8E87460E-053E-4F51-836A-0798AA5D163E
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Freedom HouseParty/Vendor Contact Person: Patricia Hussey Contact Phone: 919-942-8083
Party/Vendor Address: 104 New Stateside Drive City Chapel Hill State: NC Zip: 27516 Department: Health
Amount: $156,415.69 Purpose: Provide Zone 4 Navigator Services Budget Code(s): 10412020-630000-
71453Vendor#34104 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No ® Contract Type: (Check
one) New ❑ Renewal X Amendment ❑ Effective Date 7/1/17 Approved by Board Yes No Agenda
Date:
This agreement is approved as to to , .d content:
7/10/2017
Department Director's Signature L6ttU1
5145A2CD945C40F... 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 EN 4fs'iiOariaYsstaandards, specifications,and requirements:
LtSA rbvvutl6 7/11/2017
Office of the Risk Management Officer 7FDCF9176800498... Date:
Financial Services
This instrument has been pre-audited i eDifffiffitiuft quired by the Local Government Budget and Fiscal Control Act:
("
An °'Z 0 7/11/2017
Office of the Chief Financial Officer D4ES,aIACCian9 Date:
Legal Services
This agreement is approved as t e cTVP 14 lii1_sufficiency:
1' Aunt, SCb
7/11/2017
Office of the County Attorney 07g44.0 ,5COF4FR 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:
Page 7 of 6
Revised 5/2016