HomeMy WebLinkAboutR 2017-476-E Finance - Charles House Association - Outside Agency Performance Agreement DocuSign Envelope ID:8E4BA2A0-F8F0-406A-A380-E6C66CCD78B4
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Charles House Association Party/Vendor Contact Person: Paul Klever Contact Phone: 919-
967-7570 Party/Vendor Address: 7511 Sunrise Road City Chapel Hill State: NC Zip: 27514 Department: Finance
& Administrative Services Amount: 22500 Purpose: FY 2017-18 Outside Agency Performance Agreement Budget
Code(s): 10495050710029 Vendor# 800031 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No®
Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 7/1/2017 Approved by Board
Yes No Agenda Date: 6/20/2017
ocu gned
This agreement is approved as to technical orm
D an cotnt:
eqt "°,1.4t ia,vg. 8/31/2017
Department Director's Signature 7D4E5181ACC1409_. 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 sufficiency of in $lards,specifications,and requirements:
Q�dso. Cbvvu-ttb 8/31/2017
Office of the Risk Management Officer 7Rnro, gggggg Date:
Financial Services
This instrument has been pre-audited in the mann r re` Y e5 "the Local Government Budget and Fiscal Control Act:
e'p 0,441 dia,'g. 8/31/2017
Office of the Chief Financial Officer 7D4E5181ACC14O9. Date:
Legal Services
This agreement is approved as to legal form n IgffITOT8�$A�y�:��
QU,UL 4ytL 1 SCb 9/5/2017
Office of the County Attorney naLzia 25cnE9.Ea_ 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:
(Charles House Association)
Orange County Outside Agency Performance Agreement Page 7 of 10
Rev. 7/17