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DocuSign Envelope ID:OA47CF05-5273-4BB2-BC6B-7213ED83973C <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Marie Rossettie Party/Vendor Contact Person: Marie Rossettie Contact Phone: 9195905853 <br /> Party/Vendor Address: 1439 Smith Level Rd City Chapel Hill State: NC Zip: 27516 Department: <br /> COUNTYMGR/Arts Commission Amount: 1650.49 Purpose: 2019-20 Arts Grants Budget Code(s): 37601020- <br /> 683001 Vendor# 64707 (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 tec 4D.—Signed by: it: <br /> 10/1/2019 <br /> Department Director's Signature_ OA3E81BUB364M . 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 sufficient-•_`'ciiSigPned_�`�`Tds,specifications,and requirements: <br /> USX (,bV1n.t 6 10/8/2019 <br /> Office of the Risk Management Officer Date: <br /> 7FOCF91768004M. <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: DocuSigned by: <br /> 10/8/2019 <br /> Office of the Chief Financial Officer 1ACC Date: <br /> - 704E5181409. <br /> Legal Services <br /> This agreement is approved as to I—ml form and cnffiiciency: <br /> OocuSigned by: <br /> 10/8/2019 <br /> Office of the County Attorney Date: <br /> Date: <br /> 4035CB8304CA4M <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 />