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� I <br /> ORANGE COUNTY---DEPARTMENT USE ONLY---HARD COPY ONLY <br /> Department <br /> ,Party/Vendor Name: Nantucket Grill, Inc. Party/Vendor Contact Person: Jerry Sullivan Contact Phone: <br /> Party/Vendor Address: P O Box 2655 City Chapel Hill State: NC Zip: 27515 Department: Aging Amount: <br /> 250 000 Purpose: Senior Lunch Program Budget Code(s): 10430120-630000-71086& 10430020-630120 Vendor <br /> 40866 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New <br /> Renewal ® Amendment ❑ Effective Date 7/01/2017 Approved by Board Yes®No❑ Agenda Date: <br /> 6/21/2016 <br /> This agreement is approved as to technical form and content: <br /> Department Director's Signature Q L.. Date: e-,?`17 <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 <br /> i") Date:17 <br /> Financial Services <br /> This instrument has been pre-audited in the anne ui d by the Local Government Budget and Fiscal Control <br /> Act: <br /> Office of the Chief Financial Officer Date: 717117 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> Office of the County Attorney �i (,�/U klAr Date: <br /> Clerk to the Board <br /> Received for record retention: <br /> Office of the Clerk to the Board f Date: V/vf <br /> 7 <br /> Revised 2/17 <br />