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DocuSign Envelope ID:9869FE04-E616-4197-8F91-615B920DBC72 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Quantworks, Inc. Party/Vendor Contact Person: Nick Ghitelman Contact Phone: 919-923- <br /> 4469 Party/Vendor Address: 976 Martin Luther King, Jr. Blvd, Suite 250 (J, K, L, M) City Chapel Hill State: NC <br /> Zip: 27514 Department: Economic Development Amount: $5,000.00 Purpose: Business Investment Grant <br /> Award Budget Code(s): 34600020-900051 Vendor# N/A (N/A if new vendor) Vendor is a BOCC consultant? <br /> Yes ❑ No® Contract Type: (Check one) New® Renewal ❑ Amendment ❑ Effective Date August 16, 2016 <br /> Approved by Board Yes❑ No❑ Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> Docu5igned by:p,-. <br /> �� �'�''"x 8/21/2016 <br /> Department Director's Signature uuQ4EFAC1 BE410_. Date: <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,o IY%6 `cV:standards, specifications, and requirements: <br /> ov�,t,{�a <br /> Office of the Risk Management Officer Q�isa Date: 8/22/2016 <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: DocuSigned by: <br /> SlJ2osz <br /> Office of the Chief Financial Officer 1ACC1409... Date: 8/22/2016 <br /> Legal Services <br /> This agreement is approved as to(7i9PT&M'�'-d sufficiency: <br /> aylit,S 15 av <br /> Office of the County Attorney i9RfH14snS4Q�FS Date: 8/23/2016 <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 />