Orange County NC Website
DocuSign Envelope ID:70E97245-CBDE-4A68-90A8-9FB875F7C092 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Dawn Hummer Party/Vendor Contact Person: Dawn Hummer Contact Phone: 512-924-1136 <br /> Party/Vendor Address: 837 Kenmore Rd. City Chapel Hill State: NC Zip: 27514 Department: <br /> COUNTYMGR/Arts Commission Amount: 1500.00 Purpose: 2017-18 Arts Grants Budget Code(s): 37601020- <br /> 683001 Vendor# 64415 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No Contract Type: <br /> (Check one)New® Renewal ❑ Amendment ❑ Effective Date 8/17/2017 Approved by Board Yes No <br /> Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> DocuSigned by: <br /> Department Director's Signature tra\uS ItiuiruA, 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 /> /I <br /> DocuSigned by: <br /> Office of the Risk Management Office QUSX C,bV'I�t,t,{tb Date: 8/24/2017 <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: <br /> ,---DocuSigned by: <br /> Office of the Chief Financial Officer (16 A" .A.x. Date: 8/25/2017 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as tocle-gtaefouxicood sufficiency: <br /> Office of the County Attorney ahbt�, � SCb Date: 9/5/2017 <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 />