HomeMy WebLinkAboutR 2019-199 Social Svc - Carolina Outreach counseling services DocuSign Envelope ID:C225CBFC-BC74-450D-8FD7-99E8F2A23E98
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Carolina Outreach, LLC Party/Vendor Contact Person: Holly Duggan Contact Phone: 919-
251-9001 Party/Vendor Address: 2670 Durham-Cha el Hill Blvd. City Durham State: NC Zip: 27707
Department: Social Services Amount: $30,000 Purpose: co-located therapist Budget Code(s): 10400220-761005
Vendor#59359 (NIA if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type:(Check one)
New ® Renewal ❑ Amendment ❑ Effective Date 3/8/2019 Approved by Board Yes❑No❑ Agenda
Date:
This agreement is approved as to technical form and content and I as Department Director affirmatively state work
on this project has not been initiated prior to execution of the agreement:
DocuSigned by:
NOUN Ct� (hs bv, 3/21/2019
Department Director's Signature D,4€1F1A...1 9 Date:
Agreements for emergency services or repair are not subject to the above affirmation. If services related to this
agreement have already begun or been completed please briefly describe the nature of the emergency condition that
was addressed:
Information Technologies
(Applicable only to hardwarelsoftware 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 sufficienc daa g`wtuystandards,specifications, and requirements:
Q�1Sa C,bvvi t llb 3/13/2019
Office of the Risk Management Officer saoeasa Date:
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act: DocuSigned by:
4� 3/25/2019
Office of the Chief Financial Officer t'D4Es,s1ACE14-0 ... Date:
Legal Services
This agreement is approved as to(ft&pqA!1fte1Jbd sufficiency:
Office of the County Attorney ` Date 3/28/2019
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@orangecountyne.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:
Revised 12/18
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