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Revised 2/17 <br />ORANGE COUNTY---DEPARTMENT USE ONLY---HARD COPY ONLY <br />______________________________________________________________________________ <br />Department <br />Party/Vendor Name: Fireside FarmParty/Vendor Contact Person: Randall WilliamsContact Phone: 919-698- <br />1228Party/Vendor Address: 6323 Mt. Mitchell Rd City EflandState: NC Zip: 27243 Department: Economic <br />DevelopmentAmount: $10,000.00Purpose: Agriculture Grant AwardBudget Code(s): 34-34600020-900050 <br />Vendor # (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check <br />one) New Renewal Amendment Effective Date 7/18/18Approved by Board Yes No Agenda <br />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 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 />Office of Risk Management_____________________________________________ Date: _________ <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 />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: <br />Office of the Clerk to the Board __________________________________________Date:_________ <br />DocuSign Envelope ID: 70D1A46A-4D01-41AE-BAEE-1AFACCD15A81 <br /> <br /> <br /> <br />