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DocuSign Envelope ID:23E7A146-B308-4B95-A566-082E10E68185 <br /> ORANGE COUNTY EMERGENCY LOAN PROGRAM—INTERNAL USE ONLY <br /> Department <br /> Party/Vendor Name: Dhruva Chellani Party/Vendor Contact Person: Dhruva Chellani Contact <br /> Phone: 917-667-2140 Party/Vendor Address: 200 N.Greensboro Street City: Carrboro State: NC <br /> Zip: 27510 Department: Economic Development Amount: $3,000 Purpose: Emergency <br /> Business Funding Program Budget Code(s): 48600020-900091 Vendor # N/A (N/A if new <br /> 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 /> Department Directors Signature Date:z/z5/zozl <br /> 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 /> 2/25/2021 <br /> Office of the Chief Financial Officer Date: <br /> Leal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> Office of the Count �u 2/26/2021 <br /> �,3E� Date: <br /> Y Attorney���� <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 />