R 2017-034-E Arts - Mary Scroggs Elementary PTA - Fall 2016 Arts Grant Agreement

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DocuSign Envelope ID:8098AFC6-0436-4DCB-B911-252527D 189DE ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Mary Scroggs Elementary PTA Party/Vendor Contact Person: Lynn Hirsch Contact Phone: 919-918-7165 Party/Vendor Address: 501 Kildaire Rd. City Chapel Hill State: NC Zip: 27516 Department: COUNTYMGR/Arts Commision Amount: 600.00 Purpose: Fall 2016 Arts Grants Budget Code(s): 37601020 683001 Vendor # 64272 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one)New® Renewal❑ Amendment ❑ Effective Date 1/19/2017 Approved by Board Yes❑ No❑ Agenda Date: This agreement is approved as to technical form and content: DocuSigned by: Department Director's Signatur l'V'a\uS Date: 0A3E81 B12B364B4... Information Technologies (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 of insurance standards, specifications,and requirements: DocuSigned by: Office of the Risk Management Office atSL (bfr1,U*& Date: 7FDCF9176800498... Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: DocuSigned by: Office of the Chief Financial Officer ('1 0..../.6. Date: 7D4E5181 ACC1409... Legal Services This agreement is approved as to legal form and sufficiency: ocuSigned by: Office of the County Attorne h ti Date: 4035CB8304CA4A9... Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@orangecountync.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: 6 Revised January 2017