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DocuSign Envelope ID:91 E71 F2D-9A8E-41 EB-A333-428A1042BC15 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Hillsborough Elementary School PTA Party/Vendor Contact Person: Ashley Slaughterbeck <br /> Contact Phone: 919-732-6137 Party/Vendor Address: 402 S. Nash St. City Hillsborough State: NC Zip: 27278 <br /> Department: COUNTYMGR/Arts Commission Amount: 785.00 Purpose: 2017-18 Arts Grants Budget Code(s): <br /> 37601020-683000 Vendor#32113 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑ No Contract <br /> Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date 8/17/2017 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 Signature trav,is 1141ruA, 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 /> c--DocuSigned by: �. <br /> Office of the Risk Management Officer [(USX C,bV'I�kft b Date: 8/25/2017 <br /> ``,. 7 FDC F9176800498... <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 (1 446°"L Date: 8/25/2017 <br /> \.---7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to le l fgrm and sufficiency: <br /> ocu igned y: <br /> ah, Atotvic, fibSCb 9/5/2017 <br /> Office of the County Attorney 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 />