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DocuSign Envelope ID: 1AAAAB90-CE45-4C70-BFF6-9C6B412A4075 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Hillsborough Presbyterian Church Party/Vendor Contact Person: Karen Wysocki Contact <br /> Phone: 919-732-3131 Party/Vendor Address: PO Box 717 City Hillsborough State: NC Zip: 27278 Department: <br /> COUNTYMGR/Arts Commision Amount: 375.00 Purpose: Fall 2016 Arts Grants Budget Code(s): 37601020 <br /> 683001 Vendor # 63160 (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 technboalsfo rand content: <br /> Department Director's Signatur C'r"iS kr Nu Date: 2/2/2017 <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 /> ''111i <br /> Office of the Risk Management Officer ((USX �,Orv�16 Date: 2/3/2017 <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: DocuSigned by: <br /> Office of the Chief Financial Officer <br /> r1-1- 0-1.h°'L Date: 2/8/2017 <br /> 7D4E5181 ACC1409... <br /> Legal Services <br /> This agreement is approved as to legocuSigal form and sufficiency: <br /> ned by: <br /> Office of the County Attorne _k6 Date: 2/9/2017 <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 />