HomeMy WebLinkAboutR 2019-454 Health - El Futuro mental health services DocuSign Envelope ID:44FOD66E-1905-4A6D-B2D2-D7CO2EDF751A
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: El Futuro, Inc. Party/Vendor Contact Person: Kerry Brock Contact Phone: 919-688-7101
x632 Party/Vendor Address: 136 E. Chapel Hill Street City Durham State: NC Zip: 27701 Department: Health
Amount: $53,769 Purpose: Outpatient mental health and substance abuse treatment services Budget Code(s):
10414020-630000 Vendor#57915 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract
Type: (Check one)New❑ Renewal ® Amendment ❑ Effective Date 7-1-19 Approved by Board Yes®No
❑ Agenda Date: 6-18-19
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:
S�.wo- 7/12/2019
Department Director's Signature 3C16F2D09E3445F. 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 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 sufficient �ocusigned by: rds,specifications,and requirements:
SUS& " A6 7/15/2019
Office of the Risk Management Office 7FDCFs176s004,N. Date:
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act: DocuSigned by:
A . 7/15/2019
Office of the Chief Financial Officer 7DaE5aa1ACC1409. Date:
Legal Services
This agreement is approved as DocuSigned by:
§WAk fta�Vit' 1 7/15/2019
Office of the County Attorne 079MD525COF4FB. Date:
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@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:
Revised 12/18
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