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DocuSign Envelope ID: DE1 D8FF0-BDA1-4F5A-AB39-D3DOD4764DE6 <br /> DS <br /> LI ORANGE COUNTY-DEPARTMENT USE ONLY <br /> ....................................... .......... .......____ <br /> Department <br /> Party/Vendor Name: Tile Restoration Inc Party/Vendor Contact Person: Brad Albritton, Vice President Contact <br /> ...... ------- .Albritton <br /> Plione: 866-327-4600 Party[Vendor Address: 119 East Main Street City flookerton State: NQ Zip: 28538 <br /> Department: Asset Management Services amount: 1 d 570 Purpose: flooring restoration at Southern I lurnan Services <br /> Center er proposal Budget Code(s): 10240520-630000 Vendor 9 61702 (N/A if new vendor) Vendor is a BOCC <br /> consultant? Yes E] NoZ Contract Type: (Check one) New Z Renewal n Amendment El Effective Date <br /> 02/02/2015 Approved by Board Yes❑ No[:] Agenda Date: <br /> .......... <br /> This agreement is approved as to technical form and content: <br /> DocuSigned by <br /> Department Director's Signature Date: 2/2/2015 <br /> Information Technologies <br /> (AI)pliciibleoti4i,to,hai-d,ii,ao-(-,I.�,o wrelnirchases or related services)This agreement has been reviewed and is <br /> approved as to information technology content and specifications: <br /> Office of the Chief Information Officer ..................... Date: <br /> Risk Management <br /> '['his agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> DocuSignetl by. <br /> Office of the Risk Management Officer C"6 Date: 2/4/2015 <br /> G'IM8 .......................... <br /> Financial Services <br /> 'Mis instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> D­S,gn,d by 2/4/2015 <br /> O,ffice of the Chief Financial Officer au WVJ46v, Date: <br /> .............. <br /> 'I-232DFFC2CFA247B <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: <br /> Office of the County Attorney Date:-2/5/2015 <br /> EAA3D33E D8A84fi5... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must he copied to Donna Lloyd Upon completion @ t)oll_ovd(ii)qLIngccoqntviic.0, v <br /> The following signature block is for hard copies only and is not required for Docusign contracts: <br /> Office of the Clerk to the Board Date: <br /> ............ <br /> Revised, 10114 4 <br />