HomeMy WebLinkAboutR 2018-751 Finance - The Art Therapy Institute performance agreement(The Institute of Art Therapy)
Orange County Outside Agency Performance AgreementPage 7of 9
Rev. 8/18
ORANGE COUNTY—DEPARTMENT USE ONLY
______________________________________________________________________________
Department
Party/Vendor Name: The Institute of Art TherapyParty/Vendor Contact Person: Hillary RubesinContact Phone:
919-381-6068Party/Vendor Address: 200 N. Greenboro St., Suite D-6City CarrboroState: NCZip: 27510
Department: Finance and Administrative ServicesAmount: 31,155Purpose: FY 2018-19 Outside Agency and Mental
Health Performance AgreementBudget Code(s): 10495050-720109 Vendor # 63288(N/A if new vendor) Vendor
is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective
Date 7/1/2018Approved 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 ChiefInformation 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: 4FF28E49-EE56-4A40-9331-F55AA8A05998