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DocuSign Envelope ID:A93DFB16-F899-47A7-98E9-B1FBA2F2F1B5 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Mary Scroggs Elementary School PTA Party/Vendor Contact Person: Crystal Epps Contact <br /> Phone: 919-918-7165 Party/Vendor Address: 501 Kildaire Rd. City Chapel Hill State: NC Zip: 27516 <br /> Department: COUNTYMGR/Arts Commission Amount: 2146.00 Purpose: 2017-18 Arts Grants Budget Code(s): <br /> 37601020-683000 Vendor#64272 (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 Signatur tr1 .1S rUA, 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 /> r----DocuSigned by: <br /> ' <br /> Office of the Risk Management Officer <br /> aus Cw"vi-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 Office (1 4441.°6"."- Date: 9/1/2017 <br /> 7D4E5181 ACC1409... <br /> Legal Services <br /> This agreement is approved as totlegglisoml sufficiency: <br /> uffict iency: <br /> 9/5/2017 <br /> Office of the Count y Attorne y likk , Auvit, -1- ste, Date: <br /> `^β€”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 />