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DocuSign Envelope ID: 17FD95EB-B331-47B7-938C-49C2A49A7089 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Sean T. Bailey Party/Vendor Contact Person: Sean T. Bailey Contact Phone: 919-559-1655 <br /> Party/Vendor Address: 2408 Summit Dr City Hillsborough State: NC Zip: 27278 Department: <br /> COUNTYMGR/Arts Commission Amount: 1562.62 Purpose: 2019-20 Arts Grants Budget Code(s): 37601020- <br /> 683001 Vendor# 65831 (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 /> DocuSigned by: <br /> Department Director's Signature fi S ru , Date: 10/1/2019 <br /> OMEMUB364B4... <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 &A, r,OVln.t,h Date:10/10/2019 <br /> C- 7MCF9176800498 <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 0.411. Date: 10/10/2019 <br /> 7NE5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: <br /> Office of the County Attorney Data <br /> 10/10/2019 <br /> 4035CB8304CA4A9... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ DolloydAoran eg countync. og_v <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 />