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DocuSign Envelope ID:40ED28D4-4078-4818-97B6-DF4F08683001 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Belgian Waffle Crafters Party/Vendor Contact Person: Francois Kerckhof Contact <br /> Phone: 919-260-4263 Party/Vendor Address: 2500 Booker Creek Road City Chapel Hill State:NC Zip: <br /> 27514 Department: Economic Development Amount: $10,000.00 Purpose: Business Investment Grant <br /> Award Budget Code(s): 34600020-900051 Vendor#N/A (N/A if new vendor) Vendor is a BOCC <br /> consultant? Yes ❑No® Contract Type: (Check one)New® Renewal❑ Amendment ❑ Effective <br /> Date February 12, 2016 Approved by Board Yes❑Nor-1 Agenda Date: <br /> This agreement is approved as to techn FeJtqiVffAd'content: <br /> e $444`116y 2/18/2016 <br /> Department Director's Signature �!7BD4EFAC1BF-4in Date: <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services) This agreement has been reviewed <br /> and is 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 sufficient o I f'i"bb� �s�tandards, specifications, and requirements: <br /> QUSa rwc X16 2/18/2016 <br /> Office of the Risk Management Officer 7FDCF9176800498... Date: <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal <br /> Control Act: DocuSigned by: <br /> Office of the Chief Financial Officer4g,A ,4o Date: 2/19/2016 <br /> Legal Services <br /> This agreement is approved as to 1 g,3Ff0fl f!Md sufficiency: <br /> �a.wit,s 15rV as u 2/19/2016 <br /> Office of the County Attorney 328DC480549A4F5... Date: <br /> Clerk to the Board <br /> Received for record retention: <br /> All DocuSign contracts must be copied to Donna Lloyd upon completion @ <br /> Dolloydkoran eg countync.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 /> OCEDbiga July 2015 <br />