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DocuSign Envelope ID:41A7B1F9-5095-475D-BEDD-BA78B97467EF <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Hansell Painting Co. LLC Parry/Vendor Contact Person: Philip Hansen Contact Phone: <br /> (919) 599-5994 Party/Vendor Address: 606 United Drive City Durham State: NC Zip: 27713 Department: <br /> DEAPR Amount: $4,064 Purpose: Blackwood Farm paint removal and repainting front porch Budget Code(s): <br /> 61370035 880000 20000 Vendor#N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® <br /> Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date July 20'h, 2015 Approved by <br /> Board Yes❑No® Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> DocuSignedd by: <br /> Department Director's Signature 5av't toiju 'L Date: 7/17/2015 <br /> 611CFA1D507A495... <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 Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards, specifications,and requirements: <br /> DocuSigned""by: <br /> ''� <br /> Office of the Risk Management Officer r—Ausa, 66vvt,e 6 Date: 7/19/2015 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: <br /> --- + __ <br /> DocuSigned by: <br /> Office of the Chief Financial Officer INAL l 61VU Date: 7/20/2015 <br /> 232DFFC2CFA847B... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> Signed by: <br /> Office of the County Attorney 56Z, otxfS Date: 7/21/2015 <br /> EAAMKEMA8465._ <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@orangetync.gov <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 /> Revised 10/14 5 <br />