HomeMy WebLinkAboutR 2018-442 Finance - Community Empowerment Fund outside agency agreement(Community Empowerment Fund)
Orange County Outside Agency Performance Agreement Page 6 of 9
Rev. 7/18
ORANGE COUNTY—DEPARTMENT USE ONLY
______________________________________________________________________________
Department
Party/Vendor Name: Community Empowerment Fund Party/Vendor Contact Person: Janet Xiao Contact Phone:
919-200-0233 Party/Vendor Address: 208 N. Columbia Street, Suite 100 City Chapel Hill State: NC Zip: 27514
Department: Finance & Administrative Services Amount: 15625 Purpose: FY 2018-19 Outside Agency/Human
Services Performance Agreeement Budget Code(s): 10495050-719064 Vendor # 61695 (N/A if new vendor)
Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment
Effective Date 7/1/2018 Approved by Board Yes No Agenda Date: 6/19/2018
This agreement is approved as to technical form and content:
Department Director’s Signature ________________________________________ 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 insurance standards, specifications, and requirements:
Office of the Risk Management Officer___________________________________ Date: _________
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer ____________________________________ Date: _________
Legal Services
This agreement is approved as to legal form and sufficiency:
Office of the County Attorney __________________________________________Date: ________
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Sherri Ingersoll upon completion @ singersoll@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:_________
DocuSign Envelope ID: CC5DDEFF-F35B-45F1-AD01-4586504D8AF6