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DocuSign Envelope ID:AE2B12D7-7909-4156-972E-5CD39EDFB2FC <br /> ORANGE COUNTY EMERGENCY LOAN PROGRAM—INTERNAL USE ONLY <br /> Department <br /> Party/Vendor Name: Gem Custom Jewelry, Inc. Party/Vendor Contact Person: Melissa Booth <br /> Contact Phone: 919-643-2600 Party/Vendor Address: 116 S. Churton Street City: Hillsborough <br /> State: NC Zip: 27278 Department: Economic Development Amount: $3,000 Purpose: <br /> Emergency Small Business Funding Program Budget Code(s): 48600020-900091 Vendor# N/A <br /> (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 /> 2/19/2021 <br /> Department Director's Signature Date: <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 /> 2/19/2021 <br /> Office of the Chief Financial Officer C e Date: <br /> Leal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> Office of the County Attorney 1�Poufs Date: 2/19/2021 <br /> .� <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to the Clerk upon completion: <br /> 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 /> Esbfp 070120 v1 <br />