HomeMy WebLinkAboutR 2019-800 Aging - CBF NC bilingual social worker DocuSign Envelope ID:9A9666B2-47F7-4058-AOEC-EABA9ACAC53A
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: CBF of North Carolina Party/Vendor Contact Person: Jim Hylton Contact Phone:
Party/Vendor Address: 2640 Reynolda Rd City Winston Salem State:NC Zip: 27106 Department: Aging
Amount: $13,000 Purpose: MAP Mandarin outreach Budget Code(s): 10430020-630120 Vendor#65172 (N/A if
new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New ❑ Renewal
Amendment ❑ 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:
DocuSigned by:: '_
�aan.t�c - +b_ 10/15/2019
Department Director's Signature g7E9626IBF454FA.. 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 sufficiency r Wcusigned by: ' Is,specifications,and requirements:
aura. cbm_t,{�6 10/28/2019
Office of the Risk Management Officer_ Date:
7F�CF317E800498.
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act: DocuSigned by:
A 10/28/2019
Office of the Chief Financial Officer �oaES�s1ACCiao9. Date:
Legal Services
This agreement is approved as to- oocuSigned by: icy:
Office of the County Attorney_ ��35Cg8� 304CA4A�CA4 Date: 10/28/2019
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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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