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DocuSign Envelope ID:8BDA6ABE-28AD-4D4C-AE17-79316DFF4221 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Nanne.- 5th gall_all_ tig-DiaLmostics Consultants Party/Vendor Contact Person: Jeff$pAdy Contact <br /> Phone: 919-616-4715: Party/Vendor Address: 9601 Bailevwick Rd City Ealcig4 State:NQ Zip,- 2 <br /> ....... _75 15 Department:: <br /> r Amount: S1_28 9_Q Purpose: Roof retflacennent &sign are,i Yq C nty Jail Budget <br /> _2g�lting services Orang <br /> Code(s): 10240320-570001 Vendor 9 58369 (N/A if new vendor) Vendor is a BOCC consultant? Yes El Non <br /> Contract'Fype� (Check one) New E Renewal F-1 Amendment ❑ Effective Date Approved by Board Yes <br /> F]Non Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> DocuSigned by: <br /> Department Director's Signature Date: 6/1/2015 <br /> Information Technologies <br /> (Applicable only to Naar dwarelsqftivare purchases 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 /> This agreement is approved for sufficiency of insurance standards, specifications,and requirements: <br /> DocuSigned by: <br /> Office of the Risk Management Officer ('6�b Date: 6/2/2015 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the mane.QL6ggAj6pA Ay the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief inancial Officer- PMAL Date:.. 6/8/2015 <br /> Legal Services <br /> This agreement is approved as to legal form an <br /> Office of the County Attorney Date: 6/8/2015 <br /> .......... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Qo�qt"n 4g.goy <br /> The following signature block is for hard copies only and is not required far Docusign contracts: <br /> Office of the Clerk to the Board Date: <br /> Revised 10/14 4 <br />