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DocuSign Envelope ID: 5D512265-377E-4DF8-BOA6-19210828B197 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Pathways Elementary School Party/Vendor Contact Person: Patricia Harris Contact Phone: <br /> 919-732-9136 Party/Vendor Address: 431 Strouds Creek Rd. City Hillsborough State: NC Zip: 27278 <br /> Department: COUNTYMGR/Arts Commission Amount: 758.00 Purpose: 2017-18 Arts Grants Budget Code(s): <br /> 37601020-683000 Vendor# 178 (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 : <br /> Department Director's Signature tie"S Date: 8/23/2017 <br /> OA3E81 812636484... <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 /> Office of the Risk Management Office LISA. C6vvu,tt0 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: <br /> DocuSigned by: <br /> Office of the Chief Financial Officer ( 't '6°'�`'"‘6°""I''' Date: 8/25/2017 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> D <br /> ocuSigned by: <br /> Office of the County Attorney <br /> at/UAL t. 1-6S0 <br /> 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 />