HomeMy WebLinkAboutR 2017-513-E Finance - EmPOWERment, Inc. - Outside Agency Performance Agreement DocuSign Envelope ID:72266CE5-DF5A-471 E-B671-CC65C8960691
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: EmPOWERment, Inc. Party/Vendor Contact Person: Delores Bailey Contact Phone:
9199678779 Party/Vendor Address: 109 N. Graham Street, Suite 200 City Chapel Hill State: NC Zip: 27516
Department: Finance &Administrative Services Amount: 27500 Purpose: FY 2017-18 Outside Agency Performance
Agreement Budget Code(s): 10495050789005 Vendor # 800065 (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
DocuSi n d by:
This agreement is approved as to technic 1 form1'Pi f cspn
Department Director's Signature 04E5181ACCCC1409... Date: 8/31/2017
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 i Nfieteigtvitit4rds,specifications, and requirements:
MSi. rbY1A,th 9/14/2017
Office of the Risk Management Officer 7FDCF9176800498... Date:
Financial Services
This instrument has been pre-audited in the man r retittearlythe Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Offceraa,nc-lanam Date: 8/31/2017
Legal Services
This agreement is approved as to legal fo a12O'lzeehcy:
t AAA . Aunt,
1 SCo 9/14/2017
Office of the County Attorney 079,gd1595(DEAER 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:
(EmPOWERment,Inc.)
Orange County Outside Agency Performance Agreement Page 7 of 10
Rev. 7/17