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DocuSign Envelope ID: 3D856AC8-14D5-4DCB-A90E-EAOCDAF33667 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: 5t' Wall Building Diagnostics Consultants Party/Vendor Contact Person: Jeff Spady <br /> (jeffa,5thwallbdc.com Contact Phone: 919.616.4715 Party/Vendor Address: 9601 BaileMick Road City Raleigh <br /> State: NC Zip: 27615 Department: AMS Amount: 9,100.00 Purpose: Central Rec Roof Replacement Budget <br /> Code(s): 61370035-882000-30002 Vendor#58369 (N/A if new vendor) Vendor is a BOCC consultant? Yes ®No <br /> ❑ Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date July 29, 2016 Approved by <br /> Board Yes❑No® Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> D 5 g e d by: <br /> Department Director's Signature Y.# Date: 7/21/2016 <br /> �9F88DAk6, <br /> Information Technologies <br /> (Applicable only to harchvare/sofAvare 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 /> D Sy dby: <br /> Office of the Risk Management Office lL(sa �av c f{a Date: 7/21/2016 <br /> �iFL.,FYi]SS.J3� <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> D Sg dby <br /> 0_& 7/21/2016 <br /> Office of the Chief Financial Officer Date: <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> Do uSigned by: <br /> �olun I°et7�v{s 7/22/2016 <br /> Office of the County Attorney Date: <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 6/16 5 <br />