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DocuSign Envelope ID:AA4D52F4-E4D6-4FB4-9B1 D-E18606475C71 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Jenks Miller Party/Vendor Contact Person: Jenks Miller Contact Phone: 919-633-1522 <br /> Party/Vendor Address: 5703 Buckhorn Rd. City Efland State: NC Zip: 27243 Department: COUNTYMGR/Arts <br /> Commission Amount: 1500.00 Purpose: 2017-18 Arts Grants Budget Code(s): 37601020-683001 Vendor#64713 <br /> (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one) New <br /> Renewal ❑ Amendment ❑ Effective Date 8/17/2017 Approved by Board Yes No Agenda Date: <br /> This agreement is approved as to technical Jor tband content: <br /> Department Director's Signatur trti t' Date: 8/23/2017 <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 /> r----DocuSiggned"by: <br /> '�. <br /> Office of the Risk Management Officer [(USX CortA ..ffb Date: 8/25/2017 <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 rIAo ��� Date: 8/25/2017 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to le al form and sufficiency: <br /> ocuSigneend""byy�:''���� <br /> aIIUAL, ovtAYtl, -Nto 9/5/2017 <br /> Office of the County Attorne Date: <br /> 079A4D525C0F4FB... <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 August 2017 <br />