HomeMy WebLinkAboutR 2018-752 Finance - The Arc of the Triangle performance agreement(The Arc of the Triangle)
Orange County Outside Agency Performance AgreementPage 7of 9
Rev. 8/18
ORANGE COUNTY—DEPARTMENT USE ONLY
______________________________________________________________________________
Department
Party/Vendor Name: The Arc of the Triangle Party/Vendor Contact Person: Jennifer Pfaltzgraff Contact Phone:
919-942-5119Party/Vendor Address: 1709 Legion Road, Suite 100City Chapel HillState: NCZip: 27514
Department: Finance and Administrative ServicesAmount: 39,928Purpose: FY 2018-19 Outside Agency and Mental
Health Performance AgreementBudget Code(s): 10495050-719023Vendor # 50706(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: 9F461F1C-C86C-42DC-B78C-50FC18D204DF