HomeMy WebLinkAboutR 2018-515 Finance - OC Disability Awareness Council outside agency agreementDocuSign Envelope ID: 28872B9E- 993A- 44CA- 8A5E -0BDA1 F6178CB
ORANGE COUNTY — DEPARTMENT USE ONLY
Department
Party/Vendor Name: Orange County Disability Awareness Council Party/Vendor Contact Person: Timothy Miles
Contact Phone: 919 - 245 -4337 Party/Vendor Address: 503 W. Franklin Street Room 113 City Cha ep 1 Hill State: NC
Zip: 27516 Department: Finance & Administrative Services Amount: 8,513 Purpose: FY 2018 -19 Outside
Agency /Human Services Performance Agreeement Budget Code(s): 10495050- 710032 Vendor # 800037 (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 Docusigned by:
8/28/2018
Department Director's Signature 7NE5181ACC146g... 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 insu rQocusigned ay: ificatlons, and requirements:
17FDCF9176SO04M CtSa. (,6Vlnd,{�6 8/29/2018
Office of the Risk Management Officer Date:
.
Financial Services
This instrument has been pre- audited in the manner oocusigned ay: )vernment Budget and Fiscal Control Act:
�° °� 8/28/2018
Office of the Chief Financial Officer 7oaES181ACC14a9... Date:
Legal Services
This agreement is approved as to legal form and Oocusigned by:
8/29/2018
Office of the County Attorney 4035CB8304CA4M... Date:
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Sherri Ingersoll upon completion @ sin erg soll(a)oran eg countync.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:
(OC Disability Awareness Council)
Orange County Outside Agency Performance Agreement Page 6 of 9
Rev. 7118