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DocuSign Envelope ID:95F69654-lAE0-4DB1-B46F-D3lB6C9E5334 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> De irtment <br /> Party/Vendor Name: Capital Building Consultants Party/Vendor Contact Person: Eddie Brown Contact Phone: 336 <br /> 775-1904 Party/Vendor Address: 11040 Old US 52 City Winston Salem State:NC Zip: 27107 Depariment:DEAPR <br /> Amount: $7.000 Purpose: Cost estimating Budget Code(s): PO 9 1502283 Vendor # 63072 (NIA if new vendor) <br /> Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New ❑ Renewal El Amendment <br /> Effective Date 10/l/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 I vavt SfainAul. Date: <br /> 611CFA1 D507A495... <br /> Information Teelnmlo ies <br /> (Applicable oril},to hardtirare/sq/tivare 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 Q�tSa vvte tt0 Date: <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 l(fbin, Date: <br /> 232DFF..CFA847B... <br /> LeEal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> �DocuSigned : <br /> Office of the County Attorney Date: <br /> 8465... <br /> Cleric to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion a Dolloyd(?orangeeountyn�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 10114 4 <br />