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DocuSign Envelope ID: DD71 EB1 B-0644-4A4C-819B-B3C77A254595 <br /> ORANGE COUNTY EMERGENCY LOAN PROGRAM—INTERNAL USE ONLY <br /> Department <br /> Party/Vendor Name: Lady Edison, LLC Party/Vendor Contact Person: Sam Suchoff Contact <br /> Phone: 919-636-2005 Party/Vendor Address: 630 Weaver Dairy Rd suite 101 City: Chapel Hill <br /> State:NC Zip: 27514 Department:Economic Development Amount: $3,000 Purpose: Emergency <br /> Small Business Funding Program Budget Code(s): 48600020-900091 Vendor# 66206 (N/A if <br /> 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 /> 3/1/2021 <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 /> 3/2/2021 <br /> Office of the Chief Financial Officer IE Date: <br /> Leal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> ^° 3/4/2021 <br /> Office of the County Attorney C °a`�"!s Date: <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 />