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ORANGE COUNTY---DEPARTMENT USE ONLY---HARD COPY ONLY <br /> Department <br /> Party/Vendor Name: NCDOT/PTD Party/Vendor Contact Person: Myra Freeman Contact Phone: 919-707-4672 <br /> Party/Vendor Address: 1550 Mail Service Center City Ralei h State: NC Zip: 27699-1550 Department: OPT <br /> Amount: 166,765 Purpose: FY2017 Grant Agreement CTP Administrative Budget Code(s): 4350-05-00-445002 V• <br /> Vendor# (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type: (Check one) Q <br /> New® Renewal X Amendment El Effective Date 7/1/16 Approved by Board Yes®No❑ Agenda Date: LU l� <br /> 1115115 D1 elf�"'�,XI <br /> w�a.s <br /> This agreement is approved as to technical form and content: <br /> Department Director's Signature Date: <br /> Information Technologies <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: V <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 /> Office of Risk Management ( J Date:_- b <br /> Financial Services <br /> This instrument has been pre-audited in the moper re uired b the Local Government Budget and Fiscal Control <br /> Act: <br /> Office of the Chief Financial Officer Date: �' 2 <br /> Legal Services <br /> This agreement is approved as to legal m d sufficie <br /> Office of the County Attorney for Date: t,�r <br /> Clerk to the Board <br /> Received for record retention: <br /> Office of the Clerk to the Board Date: � /4 <br /> Revised 6/16 <br />