HomeMy WebLinkAboutR 2018-551 Health - Leading to Change service agreementRevised 10/17
9
ORANGE COUNTY—DEPARTMENT USE ONLY
______________________________________________________________________________
Department
Party/Vendor Name: Leading to Change Party/Vendor Contact Person: Eric Rowles Contact Phone: 704-595-
1789 Party/Vendor Address: 9815 Sam Furr Road, Suite 103 City Huntersville State: NC Zip: 28078
Department: Health Amount: $6,000 Purpose: Youth and Adult Trainings to Enhance Youth Prevention Capacities
Budget Code(s): 10412020-630000-71459 Vendor # N/A (N/A if new vendor) Vendor is a BOCC consultant?
Yes No Contract Type: (Check one) New Renewal Amendment Effective Date 1/1/18
Approved by Board Yes No Agenda Date:
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 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:_________
DocuSign Envelope ID: F814C4A7-100C-424D-A226-6FA7B02096C1
1/11/2018
1/11/2018
1/11/2018
1/11/2018