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DocuSign Envelope ID: 19E4A71 B-E91 B-461 B-ABEF-84C2EFCDC386 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Greg..Tille y's Pressure Cleanin Party/Vendor Contact Person: Greg Tilley illey Contact Phone:CE19 <br /> 812-3536 PartyNendor Address: 3600 H)vy 54 West City Chapel Hill State: NC Zip: 27516 Department: DEAPR <br /> Amount: j$ 5,800 Purpose: Seal Coating Park Shelters Budget Code(s): 61370035 880000 20039 Vendor 11 45926 <br /> (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one)New ® Renewal <br /> ❑ Amendment ❑ Effective Date 10/19/2015 Approved by Board Yes❑No® Agenda Date: <br /> This agreement is approved as to technical fo9ined and content: <br /> Department Director's Signature vavt Sf Date: <br /> 611CFA1 D507A495... <br /> Information Technologies <br /> (Applicable only to har•dware/softwrrr•e pro-chases or related services)This agrcement 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 aura, r,6vvt,&b Date: <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the��anner r9pired by the Local Goverrunent Budget and Fiscal Control Act: <br /> ocuSigned b . <br /> Office of the Chief Financial Officer_ C-q °'�`�"� Date: <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to I o9 ?�he�l�d:suffcieifcy: <br /> Office of the County Attorney Jb Date: <br /> EAA3D33EDSA8465... <br /> Cleric to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion a Dollo d oran ecount ,nc.iov <br /> Tile 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 10114 4 <br />