HomeMy WebLinkAboutR 2016-468-E ED - Jay's Chicken Shack, LLC dba Jay's Chicken Shack - Business Investment Grant Agreement DocuSign Envelope ID: C52943AD-E7A1-40BD-BF8F-99DAODE88D1B
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Jay's Chicken Shack, LLC dba Jay's Chicken Shack Party/Vendor Contact Person: Kim
Mangal Contact Phone: 919-732-3591 Party/Vendor Address: 646 N. Churton Street City Hillsborough
State: NC Zip: 27278 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 August 16, 2016 Approved by Board Yes❑ No❑ Agenda Date:
This agreement is approved as to technical form and content:
Docusigned by:
$�cvc $44a.11cy 8/19/2016
Department Director's Signature z,BDdFFOC,.3P41 0 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
gocusigned by:
This agreement is approved for sufficiency f uraDce standards, specifications, and requirements:
Vln txC 8/19/2016
Office of the Risk Management Officer 7FDCF9176800498... Date:
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act: Docusigned by:
Office of the Chief Financial Officer Oq Date: 8/19/2016
Legal Services
This agreement is approved as to a a�`o °eda6d sufficiency:
Aylit's r AJA, 8/19/2016
Office of the County Attorney 11-328DC480549A4F5. Date:
Clerk to the Board
Received for record retention:
All DocuSign contracts must be copied to Donna Lloyd upon completion @ Dolloyd(a)orangecountync.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: