HomeMy WebLinkAboutR 2017-614-E Finance - Planned Parenthood South Atlantic - Outside Agency Performance Agreement DocuSign Envelope ID:Dal 3694BA-66F1-4441-9114-5334F2B6AC3D
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Planned Parenthood South Atlantic Party/Vendor Contact Person: Jenny Black Contact Phone:
919-833-7526 x6140 Party/Vendor Address: 100 S Boylan Ave City Raleigh State: NC Zip: 27603 Department:
Finance & Administrative Services Amount: 20000 Purpose: FY 2017-18 Outside Agency Performance Agreement
Budget Code(s): 10495050710013 Vendor ft 800040 (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 f aPef c�pntent:
(41.4. ,..,z 10/10/2017
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 ins anBpcff '"� 'd�s,�specifications,and requirements:
a�Sabvvt,t4Tb 11/13/2017
Office of the Risk Management Officer 7FDCF9176800498... Date:
Financial Services
This instrument has been pre-audited in the man er altffigeadMi the Local Government Budget and Fiscal Control Act:
An ,,,,z 10/10/2017
Office of the Chief Financial Officer 7D4E5181ACC1409... Date:
Legal Services
This agreement is approved as to legal form an Eby
ate, h let, 1).S(b 11/13/2017
Office of the County Attorney Date:
-079A4DG2;C-@F4FB...
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:
(Planned Parenthood South Atlantic)
Orange County Outside Agency Performance Agreement Page 7 of 10
Rev. 7/17