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DocuSign Envelope ID: 324CD765-DCA3-42C5-B339-89CADOBBF40E <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Phillips Middle School PTSA Party/Vendor Contact Person: Jen Clark Contact Phone: 919- <br /> 929-2188 Party/Vendor Address: 606 N. Estes Dr. City Chapel Hill State: NC Zip: 27514 Department: <br /> COUNTYMGR/Arts Commission Amount: 1.384 Purpose: 2017-18 Arts Grants Budget Code(s): 37601020- <br /> 683000 Vendor# 49341 (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 tec '6dju 4gia and content: <br /> Department Director's Signature t'ea�usr Date: 8/23/2017 <br /> 0A3E81 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 /> ''11LL <br /> Office of the Risk Management Officer Rsskk. �,6vvu,tt0 Date: 8/24/2017 <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 Office '' p '6°'"`�"�2°'L Date: 8/25/2017 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to le t f rm nd sufficiency: <br /> Uocusignedby: <br /> Office of the County Attorney ate' hAYlLSCb 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 />