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DocuSign Envelope ID:OC943255-48AO-4AF2-858E-714AEE815BFE <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: R.S.Jones&Associates.Inc. Party/Vendor Contact Person: J.D.Cecil Contact Phone: 919-563- <br /> 3623 Party/Vendor Address: 201 W. Clams City Mebane State: NC Zip: 27302 Department: DEAPR Amount: <br /> $4.500 Purpose: To provide land survey services necessM to produce a recordable plat for the Pope Farm conservation <br /> easeament Budget Code(s): 61370035 858044 20006 Vendor # 57711 (N/A if new vendor) Vendor is a BOCC <br /> consultant? Yes ❑ No® Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date <br /> Approved by Board Yes[]Nor-1 Agenda Date: June 21,2016 <br /> This agreement is approved as to technical form and content: <br /> DocuSigned by: <br /> Department Director's Signature FVaVLG S1 d AJA,U� Date: <br /> 611CFA1D507A495... <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 by: <br /> Office of the Risk Management Officer Pausa, (,OV'vtd 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 Act: <br /> Docu igned by: <br /> Office of the Chief Financial Officer Date: <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> uSigned by: <br /> Office of the County Attorney 56Z, r6u�s Date: <br /> EAAMKEDM8465... <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.nic.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 />