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OCEDbiga June 2016 <br /> <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />_____________________________________________________________________________ <br />Department <br />Party/Vendor Name: Always Faithful Body CareParty/Vendor Contact Person: Helen L. Haynes <br />Contact Phone: 919-357-4418Party/Vendor Address: 9000 Habitat CircleCity Chapel HillState: NC <br />Zip: 27516Department: Economic DevelopmentAmount: $1,500.00Purpose: Business Investment <br />Grant Award Budget Code(s): 34600020-900051Vendor # N/A(N/A if new vendor) Vendoris a <br />BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment <br />Effective Date February 14, 2018Approved by Board Yes No Agenda Date: <br />This agreement isapproved as to technical form and content: <br />Department Director’s Signature ________________________________________ Date: ________ <br />Information Technologies <br />(Applicable only to hardware/software purchases or related services) This agreement has been reviewed <br />and is 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 />Office of the Risk Management Officer___________________________________ Date: _________ <br />Financial Services <br />This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal <br />Control Act: <br />Office of the Chief Financial Officer ____________________________________ Date: _________ <br />Legal Services <br />This agreement is approved as to legal form and sufficiency: <br />Office of the County Attorney __________________________________________Date: ________ <br />Clerk to the Board <br />Received for record retention: All DocuSign contracts must be copied to Sherri Ingersollupon <br />completion @ Singersoll@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 />DocuSign Envelope ID: ED1C5AB6-5059-454A-9433-F11644088A74 <br /> <br /> <br /> <br />