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DocuSign Envelope ID:06859C00-0000-476D-B38B-E6A7AF18A5EC <br /> ORANGE COUNTY EMERGENCY LOAN PROGRAMINTERNAL USE ONLY <br /> Department <br /> Party/Vendor Name: Sam's Barbecue & Chop House, LLC Party/Vendor Contact Person: Sam <br /> Suchoff Contact Phone: 919-636-2005 Party/Vendor Address: 630 Weaver Dairy Rd suite 101 <br /> City: Chapel Hill State: NC Zip: 27514 Department: Economic Development Amount: $5,000 <br /> Purpose: Emergency Small Business Funding Program Budget Code(s): 34600020-900047 <br /> Vendor#N/A (N/A if new vendor) <br /> This agreement is approved as to technical form and content and I as Department Director <br /> affirmatively state work on this project has not been initiated prior to execution of the agreement: <br /> Y 5/6/2020 <br /> Department Director's Signature eero 1 $ Date: <br /> , .,ei_ e <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and <br /> Fiscal Control Act: <br /> 5/6/2020 <br /> Office of the Chief Financial Officer 0-.& ` Date: <br /> Leal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> ,�Mt s&au s°—by 5/7/2020 <br /> Office of the County Attorney �,�00080609A0F6_ Date: <br /> Clerk to the Board <br /> Received for record retention: <br /> All DocuSign contracts must be copied to Sherri Ingersoll upon completion: <br /> singersoll@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 /> Esbfpgc 043020 v0.2 <br />