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DocuSign Envelope ID: 124C6798-3E02-41 F0-A0B2-48070A27BF55 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Michael Roy Layne Party/Vendor Contact Person: Michael Roy Layne Contact Phone: <br /> 919/616-8427 Party/Vendor Address: 442 S. Main Street City Warrenton State: NC Zip: 27589 Department: <br /> EDC-Arts Commission Amount: $500 Purpose:Fall 2015 Arts Grant Award Budget Code(s): 37601020 683001 <br /> Vendor#61719 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No Contract Type: (Check one) <br /> New ® Renewal ❑ Amendment ❑ Effective Date date of County Manager's signature Approved by Board <br /> Yes No❑ Agenda Date: approval of FY16 county budget by BOCC-June 16,2015 <br /> This agreement is approved as to technical form and content: <br /> DocuSigned by: <br /> Department Director's Signature Svc $44,14i, Date: <br /> 12/21/2015 <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 /> r DDocuSigned"by: 11 <br /> Office of the Risk Management Officer <br /> Quo, Cort&A*& Date: 12/26/2015 <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 /> // 12/28/2015 <br /> Office of the Chief Financial Officer (l s�osr�l�aoz Date: <br /> S_---7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> i.--DocuSigned by: <br /> Office of the County Attorney i _kw,. Date: 12/28/2015 <br /> `---4035CB8304CA4A9... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd a,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 />