Orange County NC Website
DocuSign Envelope ID:0046FD13-057D-4CA9-B121-031E30FDA8B8 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> PartyNendor Name: Capital Building Consultants PartyNendor Contact Person: Eddie Brown Contact Plione: 336 <br /> 7754904 Party/Vendor Address: 11040 Old US 52 City Winston Salem State: NC Zip: 27107 Department: DEAPR <br /> Amount: $_,..7,000 Purpose: Cost estimating Budget Code(s): PO # 1402296 Vendor # n/a (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Clieck one) New ® Renewal ❑ Amendment ❑ <br /> Effective Date 5/6/2015 Approved by Board Yes❑No® Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> DocuSigned by: <br /> Department Director's Signature r—VaV f A,I U'L Date: <br /> 611CFA1D507A495... <br /> Information Technoloeies <br /> (Applicable only to hamAvar•e/softwar•e purchases or•related services)This agreement has been reviewed and is <br /> approved as to information tecluiology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Rislc Manama tent <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> --DocuSigned by: <br /> Office of the Risk Management Officer aura, �b Date: <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the mamier required by the Local Government Budget and Fiscal Control Act: <br /> DocuSigned by: <br /> Office of the Chief Financial Officer P bin, Date: <br /> 232DFFC-CFA847 B... <br /> LeealSeryfces <br /> This agreement is approved as to legal form and sufficiency: <br /> Signed by: <br /> Office of the Comity Attorney 5�'Z' r6k fS Date: <br /> EAAMKEMA8465... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docasign contracts must be copied to Donna Lloyd upon completion @ Dollo d i oran ecount ync. ov <br /> The following signature block is for hard copies only and is not required for DocuSign contracts: <br /> Office of the Cleric to the Board Date: <br /> Revised 10/14 4 <br />