HomeMy WebLinkAboutR 2016-155-E ED - Jeffrey C. West, DMD, PA - Business Investment Grant award DocuSign Envelope ID: 52D13933-BEC7-4F31-890D-AD99D791A702
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Jeffrey C. West, DMD,PA Party/Vendor Contact Person: Jeffrey C. West Contact
Phone: 919-636-9123 Party/Vendor Address: 601 West Rosemary Street- Ste 219 City Chapel Hill
State:NC Zip: 27516 Department: Economic Development Amount: $5,000.00 Purpose: Business
Investment Grant Award Budget Code(s): 34600020-900051 Vendor#N/A (N/A if new vendor)
Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one)New® Renewal❑
Amendment ❑ Effective Date February 12, 2016 Approved by Board Yes❑No❑ Agenda Date:
This agreement is approved as to techni igmdbvontent:
�t $'�++x�j 2/17/2016
Department Director's Signature 1�.[=[=Ac gam,,, Date:
Information Technologies
(Applicable only to hardware/software purchases or related services) This agreement has been reviewed
and is approved as to information technology content and specifications:
Office of the Chief Information Officer Date:
Risk Management
This agreement is approved for sufficient Rqrffs-Ri�a� -s tandards, specifications, and requirements:
rbV'tt,t,{{b 2/17/2016
Office of the Risk Management Officer F cFg,zsR a9a Date:
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal
Control Act: DocuSigned by:
('� 2/18/2016
Office of the Chief Financial Officer E' Date:
Legal Services
This agreement is approved as to 1 Pfbftff , d sufficiency:
�mt,S �/V't�m& 2/18/2016
Office of the County Attorney 328DC48o549A4E5... Date:
Clerk to the Board
Received for record retention:
All DocuSign contracts must be copied to Donna Lloyd upon completion @
Dolloydkoran eg countync.gov
The following signature block is for hard copies only and is not required for DocuSign contracts:
Office of the Clerk to the Board Date:
OCEDbiga July 2015