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DocuSign Envelope ID:299BB727-1089-451E-ADD8-553714352CF4 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Triangle Weavers Party/Vendor Contact Person: Janice Kohl Contact Phone: 919/240-4966 <br /> Party/Vendor Address: P.O. Box 3055 City Chapel Hill State: NC Zip: 27516 Department: EDC - Arts <br /> Commission Amount: $1,500 Purpose:Fall 2015 Arts Grant Award Budget Code(s): 37601020 683001 Vendor# <br /> 63532 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one)New <br /> Renewal❑ Amendment ❑ Effective Date date of County Manager's signature Approved by Board Yes®No <br /> ❑ Agenda Date: approval of FYI cojinty budget by BOCC-June 16,2015 <br /> This agreement is approved as to technical form and content: <br /> Docu5igned by: <br /> Department Director's Signature SZ $44!11 Date: 12/31/2015 <br /> 37BD4EFAC1BE410... <br /> Information Technologies <br /> (Applicable only to hardtivare/softivare 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 /> Docu5igned"by: <br /> '�.�. <br /> Office of the Risk Management Officer aUSX r,Orwt,�16 Date:12/31/2015 <br /> 7FDCF9176800498... <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 � a Date: 12/31/2015 <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: 1/4/2016 <br /> 4035CE8304CA4A9... <br /> Cleric to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloydgorangecountync.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 />