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DocuSign Envelope ID: 7ECOBODA-5F42-4CD3-9043-69FB256E982F <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: MdM Historical Consultants Party/Vendor Contact Person: Jennifer Martin Contact Phone: 919- <br /> 368-1602 Party/Vendor Address: PO Box 1399 City Durham State: NC Zip: 27702 Department: DEAPR Amount: <br /> $1,500 Purpose: Hester House Historic Landmark Report Budget Code(s): 61370035 870000 20006 Vendor#62927 <br /> (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one)New ® Renewal <br /> ❑ Amendment ❑ Effective Date Sept. 1,2015 Approved by Board Yes❑No® Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> DocuSigned by: <br /> I <br /> Department Director's Signature I_VaVL St11 A-In.Gll, Date: 9/14/2015 <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 rAusa, rbvvt,e,ttb Date: 9/15/2015 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> ---DocuSigned by:: '' <br /> Office of the Chief Financial Officer <br /> rP&IALl,(.fbin, Date:9/16/2015 <br /> 232DFFC2CFA847B... <br /> Legal Services . <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: <br /> Office of the County Attorney bLVU otxfS Date: 9/16/2015 <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@oran eg couniync. og_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 /> Revised 10/14 4 <br />