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<br />ORANGE COUNTY, NORTH CAROLINA <br />By: <br />PRINTED NAME OF CONTRACTOR <br />Barry Jacobs, Chair By: <br />Orange County Board of Commissioners <br />Date <br />Title: <br />Date: <br />NAME OF SUPERVISING DEPARTMENT(S): County Risk Manager <br />Signature of Department Director <br />Signature of Department Director <br />"This instrument has been pre-audited in the manner required by the Local Government Budget <br />and Fiscal Control Act." <br />FINANCE OFFICER Date <br />