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DocuSign Envelope ID:C697B35C-2F49-4AB9-83B9-59C63C836498 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: JABIN L.L.C. Party/Vendor Contact Person: Homayoon Ershadi Contact Phone: 919-909- <br /> 6075 Party/Vendor Address: 500 Valley Forge Rd. City Hillsborough State:NC Zip:27278 Department:Economic <br /> Development Amount: $1,500 Purpose: Business Investment Grant Budget Code(s): 34600020-900051 Vendor# <br /> N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New <br /> Renewal❑ Amendment ❑ Effective Date 5/4/21 Approved by Board Yes❑No® Agenda Date:N/A <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work on <br /> this project has not been initiated prior to execution of the agreement: <br /> �Department Director's Signature �" g""`�`" Date: 5/5/2021 a,aeE As <br /> Agreements for emergency services or repair are not subject to the above affirmation. If services related to this <br /> agreement have already begun or been completed please briefly describe the nature of the emergency condition that <br /> was addressed: N/A <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 /> a. �ed4 5/6/2021 <br /> Office of the Risk Management Officer ,�E Date: <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> " 5/6/2021 <br /> Office of the Chief Financial Officer [ "" Date: <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> 5/7/2021 <br /> . <br /> Office of the County Attorney ��E.�,�a�41b,aro,. Date: <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 /> Revised 07/20 <br />