HomeMy WebLinkAboutR 2017-707-E Finance - Institute of Art Therapy outside agency agreement DocuSign Envelope ID:C70973D3-D989-4F31-A95E-3BCC099C95E7
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: The Institute of Art Therapy Party/Vendor Contact Person: Hillary Rubesin Contact Phone:
919-381-6068 Party/Vendor Address: 200 N. Greenboro St., Suite D-6 City Carrboro State: NC Zip: 27510
Department: Finance & Administrative Services Amount: 300 Purpose: FY 2017-18 Outside Agency Performance
Agreement Budget Code(s): 10495050720109 Vendor # 63288 (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
This agreement is approved as to technical f Docusigned by:
Department Director's Signature 41./.114. Date: 11/27/2017
7D4E5181ACCt409...
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 Wcusigned by: Hfications,and requirements:
C�sa �w�f�a
Office of the Risk Management Officer E7FDCF9176900498
Date: 11/27/2017
Financial Services
This instrument has been pre-audited in the ma Cusigned by: Government Budget and Fiscal Control Act:
11/27/2017
Office of the Chief Financial Officer 7D4E5181ACC14o9... Date:
Legal Services
This agreement is approved as to legal form an DocuSigned by:
11/27/2017
Office of the County Attorney 079MD525COF4FE3... Date:
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@oran e� 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:
(The Institute of Art Therapy)
Orange County Outside Agency Performance Agreement Page 7 of 10
Rev. 7117