HomeMy WebLinkAboutR 2018-450 Finance - Table outside agency agreementDocuSign Envelope ID: 2AC82140 -8F6C- 4125 - 8743- OB8594E61466
ORANGE COUNTY — DEPARTMENT USE ONLY
Department
Party/Vendor Name: TABLE Party/Vendor Contact Person: Ashton Tippins Contact Phone: 919 - 636 -4860
Party/Vendor Address: 209 East Main Street City Carrboro State: NC Zip: 27510 Department: Finance &
Administrative Services Amount: 10450 Purpose: FY 2018 -19 Outside Agency /Human Services Performance
Agreeement Budget Code(s): 10495050- 720116 Vendor # 800791 (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 fo Docusigned by:
1 std 8/16/2018
Department Director's Signature 7NE5181ACC140g... 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
Risk Management
Date:
This agreement is approved for sufficiency of insui QocuSigned ay: fications, and requirements:
17MCF9176800498. 6L �,4Vln.t& 8/17/2018
Office of the Risk Management Officer . Date:
Financial Services
This instrument has been pre- audited in the mannf oocusigned ay: 3overnment Budget and Fiscal Control Act:
8/16/2018
Office of the Chief Financial Officer Date:
7oaE51s1acc,aas_.
Legal Services
This agreement is approved as to legal form OocuSigned dy:
8/17/2018
Office of the County Attorney 4035CB8304CA4Ae... Date:
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Sherri Ingersoll upon completion @ sin erg sollgoran eg countync. og_v
The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board Date:
(TABLE)
Orange County Outside Agency Performance Agreement Page 6 of 9
Rev. 7118