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ESBLPLSA <br /> <br />ORANGE COUNTY EMERGENCY LOAN PROGRAM—INTERNAL USE ONLY <br />______________________________________________________________________________ <br />Department <br /> <br />Party/Vendor Name: Hillsborough Gallery of Arts Inc Party/Vendor Contact Person: Michael Salemi <br />Contact Phone: 919-732-5001 Party/Vendor Address: 121 D North Churton Street City: Hillsborough <br />State: NC Zip: 27278 Department: Economic Development Amount: $7,973.68 Purpose: Emergency <br />Small Business Funding Program Budget Code(s): 34600020-900047 Vendor # 66207 (N/A if new <br />vendor) <br /> <br />This agreement is approved as to technical form and content and I as Department Director affirmatively <br />state work on this project has not been initiated prior to execution of the agreement: <br /> <br /> <br />Department Director’s Signature ________________________________________ Date: ________ <br /> <br /> <br />Financial Services <br /> <br />This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal <br />Control Act: <br /> <br />Office of the Chief Financial Officer ____________________________________ Date: _________ <br /> <br />Legal Services <br /> <br />This agreement is approved as to legal form and sufficiency: <br /> <br />Office of the County Attorney __________________________________________Date: ________ <br /> <br /> <br />Clerk to the Board <br /> <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 /> <br />Office of the Clerk to the Board __________________________________________Date:________ <br /> <br /> <br /> <br />DocuSign Envelope ID: 6F1DFC91-A571-4D56-8A22-33193DA8C255 <br />5/18/2020 <br />5/18/2020 <br />5/18/2020