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DocuSign Envelope ID:F7163211-DB22-463E-994F-9511800DB63B <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Chapel Hill-Carrboro Public School Foundation Party/Vendor Contact Person: Lynn <br /> Lehmann Contact Phone: 919-967-8211 Party/Vendor Address:PO Box 877 City Carrboro State: NC Zip: 27510 <br /> Department: COUNTYMGR/Arts Commision Amount: 500.00 Purpose: Fall 2016 Arts Grants Budget Code(s): <br /> 37601020 683001 Vendor#58283 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑ No Contract <br /> Type: (Check one)New ® Renewal ❑ Amendment ® Effective Date 1/17/2017 Approved by Board Yes <br /> No Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> DocuSigned by: <br /> Department Director's Signatur tP'tW-(S V't A. Date: <br /> 0A3E81B12B364B4... <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 /> /I DocuSigned by: <br /> Office of the Risk Management Office a�Sa. CbVO 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 Officer (1 0...zi L Date: 2/8/2017 <br /> 7D4E5181 ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal uSi fogrned m py:nd sufficiency: <br /> oc <br /> Office of the County Attorne -( an) 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 />