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DocuSign Envelope ID: EDA3D663-EOCD-4A89-8551-72F3CF28CEBF <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Parry/Vendor Name: MdM Historical Consultants Party/Vendor Contact Person: Jennifer Martin, Vice President <br /> Contact Phone: (919)-362-1602 Party/Vendor Address: PO Box 1399 City Durham State: NC Zip: 27702 <br /> Department: <br /> DEAPR Amount: $3,150 Purpose: Editorial/Writing for property catalog entries for Historic Resources Publication <br /> Budget Code(s): 10610020 630000 Vendor 9 62927 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ <br /> No® Contract Type: (Check one)New® Renewal❑ Amendment ® Effective Date May 15,2016 Approved by <br /> Board Yes❑No® Agenda Date:NA <br /> This agreement is approved as to technical form and content: <br /> DocuSignedd by: <br /> Department Director's Signature FoaW, SfOJA,6� Date: 5/13/2016 <br /> 611 CFA1 D507A495... <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 /> DocuSigned""by: <br /> ''��.�.. <br /> Qusa. rbrv�c,�16 Date: 5/13/2016 <br /> Office of the Risk Management Officer <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 Date: 5/20/2016 <br /> 7D4E5181ACC1409... <br /> e2al Services <br /> This agreement is approved as to legal form and sufficiency: <br /> ocuSigned by: <br /> Office of the County Attorney <br /> 56L <br /> 6, r6 Vfs Date: 5/24/2016 <br /> EAAMKEDM8465... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@orangecountync.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 1/16 4 <br />