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DocuSign Envelope ID:84B40D2F-A65A-4CE1-9724-E039FC7EF416 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Chelsea Theater Party/Vendor Contact Person: Emily Contact Phone: 919-448-1844 <br /> Party/Vendor Address: 1129 Weaver Dairy Rd. Suite AB City Chapel Hill State: NC Zip: 27514 Department: <br /> Cnty Mngr Amount: 5,000 Purpose:2020 Operations Support Grant Budget Code(s): 37601020-683010 Vendor# <br /> 65826(N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New❑ <br /> Renewal❑ Amendment ❑ Effective Date Approved by Board Yes❑No❑ Agenda Date: <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 /> DocuSigned by: <br /> Department Director's Signature v k A4Date: 82 <br /> Agreements for emergency services r repair are n subject to the above affirmation. If services related to this <br /> A3EMUB364B4... <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 /> DocuSigned by: <br /> Office of the Risk Management Officer Ffil;fA. f AIAlow Date: ,,„ ,,,, 0 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: <br /> DocuSigned by: <br /> Office of the Chief Financial Officer Date: -,1,��3/20 0 <br /> 0 <br /> �M40181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: <br /> Office of the County Attorne Date: 020 <br /> 4035CB8304CMA9... <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 /> 6 <br /> Revised October 2020 <br />