R 2016-447-E Arts - Susan Simone - Spring 2016 Arts Grant Agreement

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DocuSign Envelope ID:AD5F5195-5261-42DC-B9BC-OC3A2COAA716 ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Susan Simone Party/Vendor Contact Person: Susan Simone Contact Phone: 919-942-9773 Party/Vendor Address: 1220 Tallyho Trail City Chapel Hill State: NC Zip: 27516 Department: Art Commition Amount: $1,000 Purpose: Spring 2016 Arts Grant Award Budget Code(s): 37601020-683001 Vendor # 50270 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New Renewal❑ Amendment ❑ Effective Date- Approved by Board Yes❑No❑ Agenda Date: This agreement is approved as to tec ' nbimmmtd content: Department Director's Signature `"y Date: 8/12/2016 Information Technolosies (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer Date: Risk Management This agreement is approved for sufficiency p& jg4tandards, specifications,and requirements: L sa, (hnttftt Office of the Risk Management Officer Date: 8/13/2016 r�aseea ... Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: F cuSigned by: Office of the Chief Financial Officer � Date: 8/14/2016 �B&C-r1S4RC61409... Legal Services This agreement is approved as to .4neAilid sufficiency: Office of the County Attorney 1`� Date: 8/15/2016 Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloy(d c�orangecount.nic.gov The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board Date: 5 Revised June 2015