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DocuSign Envelope ID: D9AFB279-4BB8-4BEO-B6B5-342497BC18DB <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Northside Elementary PTA Party/Vendor Contact Person: Andrew Riggs Contact Phone: <br /> 646-498-3357 Party/Vendor Address: 350 Caldwell St. City Chapel Hill State: NC Zip: 27516 Department: <br /> COUNTYMGR/Arts Commission Amount: 1030.00 Purpose: 2017-18 Arts Grants Budget Code(s): 37601020- <br /> 683000 Vendor# 62286 (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 fo Viand content: <br /> Department Director's Signatur le"'S "' Date: 8/23/2017 <br /> 0A3E61 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 /> DocuSigned""by: <br /> ''1L <br /> Q�ASA. Cbrik,e o 8/25/2017 <br /> Office of the Risk Management Officer 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 ('b 0. -I_ Date: 8/25/2017 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: <br /> Office of the County Attorney (.Aril- 1S(b 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(a)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 />