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DocuSign Envelope ID:ACFD87FF-23BC-4094-824A-9B99BD73820B <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Acupuncture and Apothecary, LLC Party/Vendor Contact Person: Abigail Wear Contact <br /> Phone: 919-241-5395 Party/Vendor Address: 1829 East Franklin Street, Suite 900-C City Chapel Hill State: NC <br /> Zip: 27514 Department:Economic Development Amount: $1500.00 Purpose:Business Investment Grant Budget <br /> Code(s): 34600020-900051 Vendor#66219 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® <br /> Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date 1/25/21 Approved by Board <br /> Yes❑No® Agenda Date:N/A <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work on <br /> this project has not been initiated prior to execution of the agreement: <br /> D S'g d by <br /> Department Director's Signature E <br /> w�B z1�y Date: 112512021 <br /> ��A <br /> Agreements for emergency services or repair area not subject to the above affirmation. If services related to this <br /> agreement have already begun or been completed please briefly describe the nature 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 /> D S'g d by: <br /> Q(Asa Office of the Risk Management Officer �ev+n,t,f{-a C,EDrw„saAed�e Date:1/25/2021 <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> D Sgd by <br /> � <br /> Office � � � <br /> Oce of the Chief Financial Officer E„�FF Date: 1/26/2021 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> D Sig dby: 1/27/2021 <br /> Office of the County Attorney 366 r6uw Date: <br /> ---------------- <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@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 07/20 <br />