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DocuSign Envelope ID:7A5AB4B8-9295-41 DD-B32B-3611 F7D2116C <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Phillips Middle School PTSA Party/Vendor Contact Person: Elizabeth Welsby Contact <br /> Phone: 919/929-2188 Party/Vendor Address: 606 N. Estes Drive City Chapel Hill State: NC Zip: 27514 <br /> Department: EDC - Arts Commission Amount: $988 Purpose: Fall 2015 Arts Grant Award Budget Code(s): <br /> 37601020 683001 Vendor # 49341 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No <br /> Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date date of County Manager's <br /> signature Approved by Board Yes Non Agenda Date: approval of FY16 county budget by BOCC -June <br /> 16,2015 <br /> This agreement is approved as to technical form and content: <br /> c----DocuSigned by: <br /> Department Director's Signature $ .vc $4444lc,, Date: 12/22/2015 <br /> ',.--37BD4EFAC1 BE410... <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is <br /> approved as to information technology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> DocuSigned"by: <br /> '�.�. <br /> Office of the Risk Management Officer QLSo cm watt Date: 12/22/2015 <br /> °"° 7FDCF9178800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: <br /> DocuSigned by: <br /> Office of the Chief Financial Officer (1,,, Date: 12/28/2015 <br /> � 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: <br /> Office of the County Attorney � �, Date: 12/28/2015 <br /> 4 <br /> 4035CB8304CA4A9 <br /> to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@orangecountync.gov <br /> The following signature block is for hard copies only and is not required for Docusign contracts: <br /> Office of the Clerk to the Board Date: <br /> 5 <br /> Revised June 2015 <br />