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DocuSign Envelope ID:021EDE57-BA89-4F50-B24D-4B48F14E6FC9 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Tommy Lawrence Electrical Party/Vendor Contact Person: Warren Taylor Contact Phone: <br /> 336 599-4771 Party/Vendor Address: PO Box 641 City Roxboro State: NC Zip: 27573 Department: DEAPR <br /> Amount: $51,754. Purpose: Replacement Walking Track Li hg ting Budget Code(s): 61370035 880000 20039 <br /> Vendor#30928 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type: (Check one) <br /> New ® Renewal ❑ Amendment ❑ Effective Date July 19, 2016 Approved by Board Yes❑ No® <br /> Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> DocuSigned by: <br /> Department Director's Signature Fvavt Sfa'a Date: <br /> 611CFA1D507A495... <br /> Information Technologies <br /> (Applicable only to hardtivare/softivare 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 /> DocuSig/'ned"by: <br /> '�.�. <br /> Office of the Risk Management Officer Pausa, r,OV't td 6 Date: <br /> 7FDCF9176800498... <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 (' °n Date: <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> Signed by: <br /> Oce of the County Attorney 56,ocu ��ffiDate: <br /> EAAMKEDM8465... <br /> Cleric to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@oran eg countync. ov <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 6116 <br /> 8 <br />