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ORANGE COUNTY-DEPARTMENT USE ONLY <br /> NOT A CONTRACT EXHIBIT OR ATTACHMENT <br /> Department <br /> Party/Vendor Name: Cruz Concrete Experts LLC Party/Vendor Contact Person: Demetrio Cruz Contact Phone: 336- <br /> 736-0520 Party/Vendor Address: 800 Linens Street City Graham State: NC Zip: 27253 Department: Asset <br /> Managemenet Services Amount: $3,000 Purpose: Install Sidewalks and A/C Pads at RENA Community Center <br /> Budget Code(s): 61370035-880000-10054 Vendor # 62662 (N/A if new vendor) Vendor is a BOCC consultant? <br /> Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 09/05/2014 <br /> Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is approved as to tech al form and cont�en—t-- <br /> Department Director's Signatur fi L l�O Date: <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is <br /> approved as to information technology content and specifications: <br /> Office of the Director of Information Technology Date: <br /> Risk Management D ((� (� a (>n <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: SEP 1 5 2014 <br /> Office of Risk Management p,� /L Date: 7 <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 1�!/ , Date: <br /> Legal Services <br /> This agreement is approved as to legal form and su ency: <br /> Office of the County Attorney Z e: <br /> Clerk to the Board <br /> Received for record retention: <br /> Office of the Clerk to the Board Date: /ePt/e, <br /> Revised 7/14 4 <br />