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000vSign Envelope ID:00e0e0FA-o80A-4urA~^uE0-3e0110A8A1r1 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Tommy Lawrence Electrical Party/Vendor Contact Person: Warren Taylor Contact Phone: 336 <br /> 599'4771 Party/Vendor Address: P.O. Box 64 1 City Roxboro State:NC Zip: 27573 Department: DEAPR Amount: <br /> $5,393 Purpose: Electrical Cost Saving K�cxmm Budget Code(s): 01370033 880000 20039 Vendor II 20928 (N/A if <br /> new— vendor) Vendor is a BOCC consultant? Yes No 4 Contract Type: (Check one) New El Renewal 1] <br /> Amendment 0 Effective Date 12/3/2015 Approved by Board Yox0NoEl Agenda Date: <br /> This agreement ix approved xxm technical form xand. t <br /> cootou <br /> � <br /> DocuSigned by <br /> Department Director's Signature y'�-G gatit Date: <br /> ''*---m/oFA,om'mo ' <br /> Information Technologies <br /> (Applicable only mhmd`vma6oft`vum purchases m'related services)This agreement has been reviewed and is <br /> approved as to in formation technology content and specifications: <br /> Office of the Chief lnforiiia(ion Officer Date: <br /> Risk&Youusamou( <br /> This agreement is approved for sufficiency of insurance standards, specifications,and requirements: <br /> ' <br /> DocuSigned by: <br /> � <br /> Office of the Risk��uoxgo/mxut0Dl ((USX SX C« vkft» Date: <br /> `^—*omyvo80v49o- <br /> Financial Services <br /> This instrument has been pre-audited in the natidtunssivired jired by the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer rl Date: <br /> �--7o4s5181AC*1409- <br /> Legal Services <br /> This agreement is approved as to d ffioieoxy: <br /> Office of the County Attorney j°°°" /`°~`°'' Date: <br /> `--s^^3D3so8A865.' <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd a,orangecountync.gov <br /> The following signature block is for hard copies only and is not required for Docusign contracts: <br /> Office of(he Clerk to the Board Date: <br /> Revised 10/14 5 <br />