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DocuSign Envelope ID: FB597B40-4DE1-4981-8825-EF5230CC184A <br /> ORANGE COUNTY---DEPARTMENT USE ONLY---HARD COPY ONLY <br /> Department <br /> Party/Vendor Name: Elise Bortz,dba Elysian Fields Farm Party/Vendor Contact Person: Elise Bortz Contact Phone: <br /> 919-357-6793 Party/Vendor Address: 5925 Oakley Road City Cedar Grove State: NC Zip: 27231 Department: <br /> Economic Development Amount:$6,341.00 Purpose:AR Economic Development Grant Budget Code(s):34600020- <br /> 900050 Vendor#N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type:(Check <br /> one)New® Renewal❑ Amendment ❑ Effective Date 1/25/21 Approved by Board Yes❑No® Agenda <br /> Date:N/A <br /> This agreement is approved as to technical form and content: <br /> D Sig—by: 1/26/2021 <br /> Department Director's Signature �""g`" `� Date: <br /> Information Technolouies <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 Manauement <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> Sa 1/26/2021 <br /> Office of Risk Management A,�....... e Date: <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> Sa,dby: 1/26/2021 <br /> Office of the Chief Financial Officer 0__/ " Date: <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> LSD,:ign,dby 1/27/2021 <br /> ,Office of the County Attorney _.,,. Date: <br /> Clerk to the Board <br /> Received for record retention: <br /> Office of the Clerk to the Board Date: <br /> Revised 6/16 <br />