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DocuSign Envelope ID:3F298E85-795E-4517-9AC0-9 FEDA409614B <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Ephesus Road Elementary School PTA Party/Vendor Contact Person: Victoria Creamer <br /> Contact Phone: 919-929-8715 Party/Vendor Address: 1495 Ephesus Church Rd. City Chapel Hill State: NC Zip: <br /> 27517 Department: COUNTYMGR/Arts Commission Amount: 1523.00 Purpose: 2017-18 Arts Grants Budget <br /> Code(s): 37601020-683001 Vendor#55065 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No <br /> Contract Type: (Check one)New® Renewal ❑ Amendment ❑ Effective Date 8/17/2017 Approved by Board <br /> Yes No Agenda Date: <br /> This agreement is approved as to to ialstim �y�nd content: <br /> Department Director's Signatur fi'�aws ' ( Date: 8/23/2017 <br /> 0A3E81812836484... <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----DocuSigned by: <br /> /I / '" 8/25/2017 <br /> Office of the Risk Management Officer ausx CovtAt,116 Date: <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: DocuSigned by: <br /> Office of the Chief Financial Office <br /> r <br /> (1p `.6°" 6°9Z Date: 8/25/2017 <br /> 7D4E5181 ACC1409... <br /> Legal Services <br /> This agreement is approved as t i , fggtispd sufficiency: <br /> ate, Aura, -Nto 8/25/2017 <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 />