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DocuSign Envelope ID:3E2A8197-2735-44CA-8810-5AD399233576 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Pam Baggett Party/Vendor Contact Person: Pam Baggett Contact Phone: 919-732-9403 <br /> Party/Vendor Address: 8800 Wilkerson Rd. City Cedar Grove State: NC Zip: 27231 Department: <br /> COUNTYMGR/Arts Commission Amount: 1365.00 Purpose: 2017-18 Arts Grants Budget Code(s): 37601020- <br /> 683001 Vendor# 63179 (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 /> 0A3E81 B128364B4... <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 /> ' <br /> Office of the Risk Management Officer <br /> aus Cbvvi-th Date: 8/31/2017 <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 ( 446°"L Date: 9/1/2017 <br /> \.---7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> 'DocuSigned by: <br /> 1 hark, fibSG6 9/5/2017 <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 />