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DocuSign Envelope ID: 131 D50716-7603-4905-88E6-3348AF487601 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Summit Design and Engineering Services Party/Vendor Contact Person: Edmond Purcell <br /> Contact Phone: 919-732-3883 Party/Vendor Address: 504 Meadowlands Drive City Hillsborough State: NC Zip: <br /> 27278 Department: Solid Waste Amount:Not to Exceed$90,000 Purpose: Surveying Budget Code(s): 50351020 <br /> 630000 Vendor 4 53403 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: <br /> (Check one)New ® Renewal ❑ Amendment ❑ Effective Date January 1,2016 Approved by Board Yes❑ <br /> No® Agenda Date: <br /> This agreement is approved as to technical form and SP[—i4b–W11 by: <br /> Department Director's Signature UjilLS&I Date: 11/16/2015 <br /> 6E763F604A144E2... <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 /> r—Ausa,DocuSigned""by:''11LL <br /> Office of the Risk Management Officer (,6vvt,e b Date: 11/17/2015 <br /> 71`DCF9176800498... <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 /> ---DocuSigned by: <br /> Office of the Chief Financial Officer '�°' �2°'L Date 11/17/2015 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> ocuSigned by: <br /> Office of the County Attorney 5b, <br /> LVU otxfS Date:11/17/2015 <br /> EAAMKEMA8465... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ DolloyLyorangecou go 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 <br /> 9 <br />