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C <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name : Town of Chapel Hill Party/Vendor Contact Person : Dwight Bassett Contact Phone : 919 - 968 - <br /> 2743 Party/Vendor Address : 405 Martin Luther King Jr . Blvd City Chapel Hill State : NC Zip : 27514 <br /> Department : Economic Development Amount : $ 2 , 000 , 000 Purpose : Inducement Grant Budget Code (s) : N/A <br /> Vendor # N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No [:] Contract Type : ( Check one) <br /> New ® Renewal ❑ Amendment ❑ Effective Date 10/28 / 19 Approved by Board Yes ® No [:] Agenda <br /> Date : 10/ 18 /2016 <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work <br /> on this project has not been initiated prior to execution of the agreement : <br /> 1 <br /> Department Director ' s Signature 44' 0 Date : <br /> Agreements for emergency services or repair are not subject to the above aftAation . If services related to this <br /> agreement have already begun or been completed please briefly describe the nalVre of the emergency condition that <br /> was addressed : <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 the Risk Management Officer dwzi aoov s � Date : A <br /> Financial Services <br /> This instrument has been pre - audited in the ma r requ ' ed by the Local Government Budget and Fiscal Control <br /> Act . <br /> Office of the Chief Financial Officer Date : ( I c <br /> egal Services <br /> This agreement is approved as to legal f rm a d suffic ' y : <br /> Office of the County Attorney Date : <br /> Clerk to the Board <br /> Received for record retention : <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion : smgersoll@orangecountync . 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 /> Revised 12/ 18 <br />