R 2016-421-E AMS - 5th Wall Building Diagnostics Consultants, Inc. for CA services for DA roof replac

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DocuSign Envelope ID: 1EECD013-D22F-4802-8089-53C5BFBAE1FC ORANGE COUNTY-DEPARTMENT USE ONLY Department Party/Vendor Name: 5"' Wall Building Diagnostics Consultants, Inc Party/Vendor Contact Person: Jeff Spady ('eftk5thwallbdc,com Contact Phone: 919.616.4715 Party/Vendor Address: 9601 Baileywick Road City Ralei State: NC Zip: 27615 Department: AMS Amount: 3,380.00 Purpose: CA Services for DA Roof Replace Budget Code(s): 61370035-882000-30002 Vendor#58369 (N/A if new vendor) Vendor is a BOCC consultant? Yes ®No ❑ Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date 7/29/16 Approved by Board Yes❑No® Agenda Date: This agreement is approved as to technical form and content: D 5 g d by: Department Director's Signature p Date: 8/5/2016 Information Technologies (Applicable only to harchvare/sofhvare purchases or related set-vices)This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer Date: Risk Management This agreement is approved for sufficiency of insurance standards, specifications,and requirements: D.-Signed by: ausa. ��6 8/5/2016 Office of the Risk Management Office Date: Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: D S g d by: Office of the Chief Financial Officen Date: 8/5/2016 Legal Services This agreement is approved as to legal form and sufficiency: Docu Signed by:fs Office of the County Attorney °�`� �0� Date: 8/5/2016 Clerk to the Board a Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@orangecountync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board Date: I i i Revised 6/16 5