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4 <br />Revised August 2020 <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br />Party/Vendor Name: Paul Neebe Party/Vendor Contact Person: Paul Neebe Contact Phone: 919-210-9394 Party/Vendor <br />Address: 1002 Highland Woods Rd City Chapel Hill State: NC Zip: 27517 Department: Cnty Mngr Amount: 600.00 <br />Purpose: Orange County Arts Support Fund Relief Grant Budget Code(s): 37601020-681070 Vendor # 51565 (N/A if new <br />vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment <br />Effective Date Approved by Board Yes No Agenda Date: <br />This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this <br />project has not been initiated prior to execution of the agreement: <br />Department Director’s Signature ________________________________________ Date: ________ <br />Agreements for emergency services or repair are not subject to the above affirmation. If services related to this agreement <br />have already begun or been completed please briefly describe the nature of the emergency condition that was addressed: <br />Information Technologies <br />(Applicable only to hardware/software purchases or related services) This agreement has been reviewed and is approved as to <br />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 />Office of the Risk Management Officer___________________________________ 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 />Office of the Chief Financial Officer ____________________________________ Date: _________ <br />Legal Services <br />This agreement is approved as to legal form and sufficiency: <br />Office of the County Attorney __________________________________________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 />DocuSign Envelope ID: F007353A-CFD0-49C4-AE30-438816836491 <br />12/2/2020 <br />12/3/2020 <br />12/8/2020 <br />12/8/2020