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HomeMy WebLinkAboutR 2019-478 DSS - Carolina Outreach counseling services DocuSign Envelope ID:987EC3F6-E183-4CB2-9D96-063C8A864FOC ORANGE COUNTY-DEPARTMENT USE ONLY Party/Vendor Name: Carolina Outreach LLC Party/Vendor Contact Person: Holly Duggan Contact Phone: 919- 251-9001 PartyNendor Address: 2670 Durham-Chapel Hill Blvd. City Durham State: NC Zip: 27707 Department: Social Services Amount: $60,000 Purpose: co-located therapist Budget Code(s): 10400220-761005 Vendor#59359 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type: (Check one) New ® Renewal ❑ Amendment [J Effective Date 7/1/2019 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: OacuSigned by: N� �65{bw 7/19/2019 Department Director's Signature pAE1E198A83B455 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 oocu5ignea 6y: '-rds,specifications,and requirements: QU56 (,4V'IA.t 6 7/16/2019 Office of the Risk Management Office Date: 7F©CF917E800498. Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: oocusigned by: A.&I. 7/19/2019 Office of the Chief Financial Officer ` o4 a1ACC1409. Date: Legal Services This agreement is approved as t OocuSigned by: icy: Office of the County Attorne -4C35C68304CA4A9 h�8' Date:7/19/2019 Clerk to the Board Received for record retention: All Docusign contracts roust 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 9