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DocuSign Envelope ID: D10D47AF-6B34-46E7-8866-5A58AA29E9A8 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> 20&itment <br /> Party/Vendor Name: Summit Design and Engineering Services, PLLC Party/Vendor Contact Person: Don Dewey <br /> Contact Phone: 919-732-3883. Party/Vendor Address: 504 Meadowlands Drive City Hillsborough State: NC Zip: <br /> 27278 Department: DEAPR Amount: 3,700 Purpose: Soil Borings Budget Code(s): 61370035 880000 20041 Vendor <br /> # 53403 (N/A if new vendor) Vendor is a BOCC consultant? Yes F-1 NoM Contract Type: (Check one)New <br /> Renewal F-1 Amendment ❑ Effective Date 1/25/2016 Approved by Board Yes❑NoM Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> DocuSigned by: <br /> Department Director's Signature No, sfa" Date: 1/26/2016 <br /> 6 1 1 1CFAlD507A495 <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 Managemen <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> DocuSigned by: <br /> Office of the Risk Management OfficerFzSa, ('6V't td 6 Date: <br /> �--7FDCF9176800498 1/26/2016 <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 Office A,,� Date: <br /> cl� 2/3/2016 <br /> 7D'4E5181ACC1409 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: <br /> Office of the County Attorney )66t, Ocyfs Date: <br /> EAAMKEDM8465... 2/4/2016 <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ !)oLkoy <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 1/16 4 <br />