Orange County NC Website
DocuSign Envelope ID: 16527E62-848E-428A-BF83-02D57E8435C9 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Phillips Middle School Party/Vendor Contact Person: Elizabeth Welsby Contact Phone: <br /> 919-929-2188 Party/Vendor Address: 606 N. Estes Dr. City Chapel Hill State: NC Zip: 27517 Department: <br /> COUNTYMGR/Arts Commision Amount: 1000.00 Purpose: Fall 2016 Arts Grants Budget Code(s): 37601020 <br /> 683001 Vendor # 62286 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: <br /> (Check one)New® Renewal❑ Amendment ❑ Effective Date 1/17/2017 Approved by Board Yes❑ No❑ <br /> Agenda Date: <br /> This agreement is approved as to technical four band content: <br /> Department Director's Signatur s I1rt Nu Date: <br /> 0A3E81 B12B364B4... <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 /> p DocuSigned by: <br /> Office of the Risk Management Officer atisa Cnuatt Date: <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 Office (214 A.t •l '- Date: <br /> 7D4E5181 ACC1409... <br /> Legal Services <br /> This agreement is approved as to le al form and sufficiency: <br /> ocuSigned by: <br /> Office of the County Attorney ks Date: <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@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 /> 6 <br /> Revised January 2017 <br />