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ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> ,qt,q a - a <br /> Party/Vendor Name: John Dee Holeman Party/Vendor Contact Person: Contact Phone: A-145=3�7-85 <br /> Party/Vendor Address: 206 Torain St. City Hillsborough State: NC Zip: 27278 Department: County Manager <br /> Amount: $500 Purpose: Music Singe Budget Code(s): 34600020 900057 Vendor# 65260 (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ <br /> Effective Date Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is approved as to technical for nd content: <br /> Department Director's Signature Date: 9 <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 the Risk Management Officer 06 � Date: Vq <br /> Financial Services <br /> This instrument has been pre-audited in th mann q ed by the Local Government Budget and Fiscal Control <br /> Act: <br /> Office of the Chief Financial Officer Date: x f " <br /> Legal Services <br /> This agreement is approved as to legal form and suf cie y: <br /> Office of the County Attorney Date:�/Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@orangecounlync.gov <br /> nc.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 /> LF2018 v.1. <br /> 7 <br />