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OCEDbiga June 2016 <br /> <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />_____________________________________________________________________________ <br />Department <br />Party/Vendor Name:West Hillsborough Restaurant Group, LLCdba Village DinerParty/Vendor <br />Contact Person: Joel BohlinContact Phone: 919-699-9686Party/Vendor Address: 600 West King <br />StreetCity HillsboroughState: NCZip: 27278Department: Economic DevelopmentAmount: <br />$5,000.00Purpose: Business Investment Grant Award Budget Code(s): 34600020-900051Vendor # <br />N/A(N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) <br />New Renewal Amendment Effective Date May 16, 2018Approved by Board Yes No <br />Agenda Date: <br />This agreement is approved 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: E1BE474A-CE5C-41CE-BA66-03D63FC5B663 <br /> <br /> <br /> <br />