R 2014-552 DEAPR - Cleve Wagstaff Stone Masonry, LLC for Stone culverts $5,980

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DocuSign Envelope ID: F4162074- 2BC7- 47BC- B784- BCEEDFDDC55C ORANGE COUNTY — DEPARTMENT USE ONLY Department PartyNendor Name: Cleve Wagstaff Stone Masonry, LLC Party/Vendor Contact Person: Cleve 1Va sg taff Contact Phone: 336 597 -1393 Party/Vendor Address: 309 Wagstaff Carver Rd. City Roxboro State: NC Zip: 27574 Department: DEAPR Amount: $5,980 Purpose: Stone culverts Budget Code(s): 61370035 880000 20000 Vendor # 58817 (NIA if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New Renewal ❑ Amendment ❑ Effective Date 9/30/2014 Approved by Board Yes❑ No® Agenda Date: This agreement is approved as to technical form and content: DocuSignedd by: Department Director's Signature Sfawu� Date: 611CFA1D507A495... Information Technolo ies (Applicable mily to har(hmre/softwam 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 Risk Manazement Date: This agreement is approved for sufficiency of insurance standards, specifications, and requirements: DocuSigned " by: ' Office of the Risk Management Officer us. (,byyte& Date: 7FDCF9176800498... Financial Services This instrument has been pre audited in the lboan t9�erApired by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer F - ' ,i_�V.R ti Date: 2F982EC44=444... Legal Services This agreement is approved as to legal form and sufficiency: DocuSigned by: Office of the County Attorney , bLvu 1°b ufs Date: EAA3D33ED8A8465... Cleric to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Doll oycl a2grangecountyne.goy The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Cleric to the Board Revised 10114 4 Date: