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DocuSign Envelope ID: B01934F7-B63A-4965-8524-09A503CBF95D <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Ephesus Road Elementary School PTA Party/Vendor Contact Person: Elizabeth Portnoy <br /> Contact Phone: 9198697579 Party/Vendor Address: 1495 Ephesus Church Rd City Chapel Hill State: NC Zip: <br /> 27517 Department: COUNTYMGR/Arts Commission Amount: 1417.30 Purpose: 2019-20 Arts Grants Budget <br /> Code(s): 37601020-683000 Vendor#55065 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No❑ <br /> Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date 10/1/19 Approved by Board <br /> Yes❑No❑ Agenda Date: <br /> This agreement is approved as tote(' <br /> 'Do'cusigned by: ' nt: <br /> 11 <br /> vMMS Ak M1A 10/1/2019 <br /> Department Director's Signature Date: <br /> 0AK81BUB364N . <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, ^W* cusigned by: ds,specifications,and requirements: <br /> Office of the Risk Management Officer QUSa L.Q�6 7FDCF0176800408. Date: 10/2/2019 <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 /> s�orx.w�ra.Office of the Chief Financial Officer Date: 10/2/2019 <br /> 704E51S1ACC1400- <br /> Legal Services <br /> This agreement is approved as t DocuSigned by: ncy: <br /> Office of the County Attorney 4035CBS04A4M Date: 10/2/2019 <br /> 3C <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 />