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15 <br /> <br /> <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br /> <br />Party/Vendor Name: Southern Harvest & Q Shack Catering Party/Vendor Contact Person: Rachelle Howard Contact <br />Phone: 919-600-0811 Party/Vendor Address: 4205 Branchwood Drive City Durham State: NC Zip: 27705 Department: <br />Housing & Community Development Amount: $5500.00 Purpose: Catering COVID+ hotelling program Budget Code(s): <br />49750020 630000 95022 Vendor # N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract <br />Type: (Check one) New Renewal Amendment Effective Date 12/13/21 Approved by Board Yes No <br />Agenda Date: <br /> <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 /> <br /> <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 /> <br /> <br />Information Technologies <br /> <br />(Applicable only to hardware/software purchases or related services) This agreement has been reviewed and is approved <br />as to information technology content and specifications: <br /> <br />Office of the Chief Information Officer___________________________________ Date: ________ <br /> <br />Risk Management <br /> <br />This agreement is approved for sufficiency of insurance standards, specifications, and requirements: <br /> <br />Office of the Risk Management Officer___________________________________ Date: _________ <br /> <br />Financial Services <br /> <br />This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal 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 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 /> <br />Office of the Clerk to the Board __________________________________________Date:_________ <br /> <br />DocuSign Envelope ID: 46AAA209-37F8-4264-B691-2868C8B31BDA <br />12/13/2021 <br />12/13/2021 <br />12/13/2021 <br />12/14/2021