HomeMy WebLinkAboutR 2016-671-E ED - Jay's Chicken Shack - Business Investment Grant Agreement DocuSign Envelope ID: 34C3530B-CA48-4354-96A4-14CAAF7A9A33
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Jay's Chicken Shack, LLC 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: $5,000.00 Purpose: Business Investment Grant
Award Budget Code(s): 34600020-900051 Vendor # N/A (N/A if new vendor) Vendor is a BOCC
consultant? Yes ❑ No ❑ Contract Type: (Check one) New ® Renewal ❑ Amendment ❑
Effective Date November 10, 2016 Approved by Board Yes ❑ No ❑ Agenda Date:
This agreement is approved as to technica 7�17RF)4F-F-A(-j UR.. cmnptent:
t B44,.x.� 11/23/2016
Department Director's Signature BE410 Date:
Information Technologies
(Applicable only to hardware/software purchases or related services) This agreement has been reviewed
and is approved as to information technology content and specifications:
Office of the Chief Information Officer Date:
Risk Management
This agreement is approved for sufficiency 5ursa$iecc I dards, specifications, and requirements:
k (,e 11/28/2016
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:
481A14 11/28/2016
Office of the Chief Financial Officer Date:
Legal Services
This agreement is approved as to le 7n,iWA&SUfficiency:
s ���� 11/28/2016
Office of the County Attorney Date:
Clerk to the Board
Received for record retention: All DocuSign contracts must be copied to Donna Lloyd upon completion
@ Dolloy ftoran ecountvnc.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 June 2016