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DocuSign Envelope ID:094C147D-86BF-4209-9925-2A2FCCACE30D <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Paul L. Wilkerson Jr. Grading Company Party/Vendor Contact Person: Paul Wilkerson Contact <br /> Phone: 919-732-2579 Party/Vendor Address: 4600 Brock Drive' City Hurdle Mills State: NC Zip: 27541 <br /> Department: Planning Amount: $2,150 Purpose: Sewer easement grading and repair Budget Code(s): 51360120- <br /> 571000 Vendor#61663 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No[] Contract Type: (Check <br /> one)New® Renewal ❑ Amendment ❑ Effective Date 5/13/2016 Approved by Board Yes❑No® Agenda <br /> Date: <br /> This agreement is approved as to tec ',&L,ppf d content: <br /> ,¢ <br /> Department Director's Signature ��"0 JI� Date: 5/16/2016 <br /> 846D10DA3CFD4C2... <br /> Information Technolosies <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'b"y: "11 <br /> Office of the Risk Management Office <br /> QuSSa rbVlnR,lt}'D Date: 6/3/2016 <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 /> ocu igned by: <br /> 6/6/2016 <br /> Office of the Chief Financial Office CC s�g2�sz, C� <br /> 7D4E5181ACC1409... Date: <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> ocuSigned by:,'�t <br /> Office of the County Attorne <br /> 66, r6uw s Date: 6/6/2016 <br /> 0EAA3D33ED8A8465... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloy(d c�orangecount.ny_c.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 />