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DocuSign Envelope ID: E1F4DFC6-A621-4843-BOOA-21CDCOEC17C7 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Ackland Art Museum Party/Vendor Contact Person: Katie Zigler Contact Phone: <br /> 9199623032 Party/Vendor Address: 101 S Columbia St City Chapel Hill State: NC Zip: 27599 Department: <br /> COUNTYMGR/Arts Commission Amount: 1601.03 Purpose: 2019-20 Arts Grants Budget Code(s): 37601020- <br /> 683000 Vendor# 683000 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: <br /> (Check one)New ® Renewal ❑ Amendment ❑ Effective Date 10/1/19 Approved by Board Yes❑ No❑ <br /> Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> UocuSigned by: <br /> Department Director's Signatures Date: 10/1/2019 <br /> CIOAK81BUB364N . <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 /> DocuSigned by: <br /> Office of the Risk Management Office aUS& CO A6 Date:10/2/2019 <br /> 7FDCF91768004M. <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 /> DocuSigned by: <br /> Office of the Chief Financial Officer 4 Date: 10/2/2019 <br /> 704E51S1ACC1409. <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> OocuSigned by: <br /> Office of the County Attorney[_4035CB8304CA4M��i, f�,ay�_ Date: <br /> 10/2/2019 <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ DolloydC&oran eg countync.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 /> 6 <br /> Revised July 2018 <br />