HomeMy WebLinkAboutR 2019-529 DSS - Diaper Bank of NC performance agreement DocuSign Envelope ID: B3FB92A5-8DCA-444B-BA7D-945F9A80BEF7
ORANGE COUNTY—DEPARTMENT USE ONLY
Departmen#
PartyNendor Name: Diaper Bank of North Carolina PartyNendor Contact Person: Michelle Old Contact Phone:
919-886-8085 PartyNendor Address: 1311 E.Club Blvd. City Durham State:NC Zip: 27704 Department: Social
Services Amount: $10,000 Purpose: Outcome Based Dialer Distribution Program Budget Code(s): 10400120-
630000 Vendor# 65126 (NIA if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type:
(Check one)New ® Renewal ❑ Amendment ❑ Effective Date July 1 2019 Approved by Board Yes❑No[]
Agenda Date:
This agreement is approved as tote(' 'D00't&gned by: ' tent:
(,t� 8/5/2019
Department Director's Signature Date:8
Information Technologies
(Applicable only to hardwarelsoftvare 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 Mana ement
This agreement is approved for suf6cienc "oocu5iggpned_by:
. -ds,specifications,and requirements:
��sa LQV1n.fb 7/16/2019
Office of the Risk Management Officer_ 7F❑CF917es00498- Date:
Financial Services
This instrument has been pre-audited' oocusigned by: the Local Government Budget and Fiscal Control Act:
� � � 8/6/2019
Office of the Chief Financial Officer ('78481ACC1409. Date:
Legal Services
This agreement is approved as t OocuSigned by: ncy:
ht-� ,ainh_ 8/6/2019
Office of the County Attorney 4035CB8304CA4A9 Date:
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd�]ad.oran eg countync.goy
The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board Date:
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